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COPYRIGHT DEPOSIT. 



CARE OF THE BODY 

— IN— 

HEALTH AND DISEASE. 




G. B. MABE. 



CARE OF THE BODY 



IN 



HEALTH and DISEASE 

WITH A COROLARY ON INDICATION 



OF 



Character, Conversation, Manners, Etc. 

BY 

G. B. MABE, M.D. 



U 



EMBRACING A SCIENTIFIC DISCUSSION OF FOOD- 
STUFFS, AIR, WATER AND DIET IN 
RELATION TO AGE. 



THE MOST COMMON DISEASES AND THEIR NURSING 

CARE AND FEEDING OF THE INFANT. 

MOST COMMONLY USED 

MEDICINES. 



THE HEART AND CIRCULATION. VISION, TASTE, 
SMELL, HEARING AND FEELING. RESPIRA- 
TION, VOICE AND PHASES OF 
HUMAN LIFE. 



WITH SOME OTHER VERY INTERESTING CHAPTERS 
ON IMPORTANT SUBJECTS, 



LIBRAHY of CONGRESS 
Two Copies Received 

OCT 31 ISU4 

^Copyrignt bury 

#LASS Ci XXc. No; 

'COPY B. 



Copyright 1904 by 
G. B. MABE, M. D. 



\A 



PREFACE. 



This little book has been written with the inten- 
tion of benefitting all its readers and I am quite 
certain that if they read it carefully, they will find 
something in it that is both interesting and benefi- 
cial to them. 

There is quite a number of subjects treated of in 
the book all of which are of the highest interest 
to all classes of persons, the young and the old and 
the middle-aged, and I sincerely hope that it will 
prove useful to all those who read it. 

G. B. MABE, M. D. 

Big Stone Gap, Virginia, April the ist, 1904. 



INDEX. 



CHATER I. 
Elements of the Human Body . . . i 

CHAPTER II. 
Beverages 7 

CHAPTER III. 
Food in Relation to Age and Condition 16 

CHAPTER IV. 
Air. . 24 

CHAPTER V. 
Bacterology 44 

CHAPER VI. 

Hygiene and Nursing 53 



Vltl INDEX. 

CHAPTER VII. 
Surgery 90 

CHAPTER VIII. 
The Proper Care of Young Children 106 

CHAPTER IX. 
What to do in Cases of Poisoning 1 30 

CHAPTER X. 
Preparation of Food and Drink 140 

CHAPTER XL 
Drugs Most Commonly Used by the Public .... 155 

CHAPTER XII. 
Nature and Art in the Cure of Disease 183 

CHAPTER XIII. 
The Heart and the Circulation 188 

CHAPTER XIV. 
Animal Heat 205 



INDEX. IX 

CHAPTER XV. 
Sensations of the Skin 216 

CHAPTER XVI. 

The Sense of Taste 227 

CHAPTER XVII. 
Voice and Speech 263 

CHAPTER XVIII. 
The Urinary Excretion 274 

CHAPTER XIX. 
Nutrition of the Body 283 

CHAPTER XX. 
The Phases of Human Life 290 

CHAPTER XXL 
Carriage of the Body 307 

CHAPTER XXII. 
Indication of Character 315 



X INDEX. 

CHAPTER XXIII. 
Does Culture Strengthen the Faculties 328 

CHAPTER XXIV. 

Friendship 337 

CHAPTER XXV. 
Conversation and Good Manners 342 



CONTENTS. 



A 

Alcoholic Beverages 10 

Air 24 

Asiatic Cholera, Spirillum of 48 

Acute Rheumatism 64 

Appendicitis 65 

Artery — wounded 134 

Alcohol 176 

Aloes 178 

Arterial Pulse 202 

Animal Heat 205 

Auditory Nerve Stimulation of 248 

B 

Beverages 7 

Alcoholic 10 

Bachteria in Water 29 

Bathing 33 

Bacteriology 44 

Baccillus Pyocyaneus 45 

of Bubonic Plague 45 

Tuberculosis 45 

Influenza 46 



Xll CONTENTS. 

Baccillus of Diphtheria . 47 

of Typhoid Fever 47 

Anthracis 48 

of Tetanus or Lock-jaw 49 

Brights Disease 88 

Brights Disease, Chronic 88 

Breeding Nose 135 

Burns. . . . 135 

Blood Pressure 196 

Bladder, Passage of Urine to 276 

Bladder, Evacuation of Urine 278 

Body, Nutrition of 283 

Body, Carriage of .... . 307 

Bowing 311 

C 

Condiments 13 

Clothing 36 

Clothing, Selections of 42 

Adulturation of 42 

Cholera, Asiatic 48 

Clinical History of some of the most 

Common Diseases 49 

Change of Climate 53 

Chronic Pulmonary Tuberculosis 54 

CerEbro Spinal Meningitis 63 

Cholera Infantum 85 

Cholera Morbus 86 

Cirrhosis of the Liver 87 

Children, Proper Care of 106 

Cut Finger *35 

Clothing on Fire 135 

Choking Child 136 



CHNTENTS. Xill 

Constipation 138 

Cinchona or Peruvian Bark 161 

Castor Oil 179 

Cod Liver Oil 182 

Carriage of the Body 307 

Character, Indications of 315 

Culture 328 

Conversation and Good Manners 342 

D 

Diphtheria 68 

Diarrhea 83 

Dysentery 84 

Diarrhea — Summer in Children in 

Drowning 133 

Drugs most Commonly used by the Public 155 

Digitalis Folia or Digitalis Leaves 173 

Death 303 

Does Culture Strengthen the Faculties 328 

Dioptric Media of the Eyeball 233 

Defects of Accommodation 238 

E 

Elements of the Human Body 1 

Exercise, Physical 34 

Erysipelas 75 

Eye, Accommodation of 235 

F 

Food, Preparation of for Eating 13 

in Relation to Age and Condition. 16 
11 in Disorders of Digestion 20 



xiv contents. 

Fish Bone in Throat 136 

Faults in Walking 309 

Friendship 337 

G 

German Measles or Rubella 72 

Gonorrhea 82 

General Nursing 95 

Gentian ae Radix or Gentian Root 172 

General Sensations 223 

H 

Human Body, Elements of the 1 

Heat, Conductivity 38 

Hygroscopicity 38 

Hygiene and Nursing. . . 53 

Heat Exhaustion 134 

Hydrargyri Chloridium Mite 155 

Heart and the Circulation 188 

Hearts Beat 201 

Hearing and Sound 242 

Human Life, Phases of 290 

I 

Intermitent Fever 58 

Indications of Character 315 

J 

Jaundice 86 

Jalapa or Jalap 172 



CONTENTS. XV 

L 

Love 33° 

M 

Materials 39 

Measles , 71 

Magnesii Sulphas 181 

Mechanism and Uses of Respiration...... 251 

Modified Movements of Respiratory Mus- 
cles 261 



N 

Nursing, General 95 

Nursing of Cholera Infantum 114 

of Whooping Cough 114 

of Mumps 116 

of Measles 117 

of Chicken Pox 118 

of Scarlet Fever 118 

of Feverish Children 119 

" of Diphtheria 120 

of Typhoid Fever 121 

of Influenza or La grippe 125 

of Pneumonia 126 

of Small Pox 128 

Nervous Prostration 134 

Nose Bleeding 135 

Nux Vomica 169 

Nature and Art in the Cure of Disease . 183 

Nutrition of the Body 283 



XVI CONTENTS. 



o 



Opium 1 64 

Oleum Ricini or Castor Oil 179 

Oleum Morrhuae or Cod Liver Oil 182 



Physical Exercise 34 

Pulmonary Tuberculosis 49 

Pulmonary Tuberculosis, Chronic 54 

Pneumonia 55 

Proper Care of Young Children 106 

Poisoning 130 

Piles or Hemorrhoids 137 

Prolapsed or Falling Bowel 138 

Prepare Epsom Salts 139 

Preparation of Food and Drink 140 

Potash Iodidum 159 

Peruvian Bark 161 

podophillum or may apple 1 82 

Pulse, Arterial 202 

Phases of Human Life 290 

Q 

QUININAE PULPHAS OR QUININE SULPHATE . . 1 62 

R 

Remittent Fever 59 

Rheumatism, Acute 64 

Rheumatism 137 

Ringworm 138 

Rochelle Salt 1 80 

Respiration, Mechanism and Uses of 251 



CONTENTS. XVll 

Respiratory Muscles, Modified Movement 

of 261 

Rising 311 

S 

Soil . : 28 

Silk 41 

Staphyloccocus Pyogenes Aureus, The ... 45 

Spirillum of Asiatic Cholera 48 

Scarlet Fever , 69 

Small Pox or Variola 74 

Scabies or Itch , 76 

Syphilis 76 

Soft Chancre . , 81 

Surgery 90 

Summer Diarrhea in Children 111 

Strychnine Poisoning 133 

Sunstroke 133 

Strangling 136 

Snake Bites 136 

Shingles 138 

Sulphur 163 

Strychnine, Some of the Uses of 171 

Sodii Sulphas or Sodium Sulphate 1 80 

Skin, Sensations of 216 

Sensations, General 223 

Smell, Sense of 229 

Standing 308 

Sitting 311 

T 

Tuberculin 46 

Typhoid Fever 56 



xv1u contents. 

Temperature, Maintenance of 209 

" Sense 220 

Taste, Sense of 227 

u 

Urinary Excretion 274 

Urine, Passage to the Bladder 276 

Urine, Evacuation of the Bladder. 278 

Usual Faults in Standing 308 

V 

Ventilation, Space Required for Good. . . 30 

Vision, Sense of 230 

Visions, Mental Operations 240 

Bi-nocular 241 

Voice and Speech 263 

W 

Wounded Artery 134 

Walking 308 

Faults in 309 

Y 

Yellow Fever 60 



CARE OF THE BODY 



-IN — 



HEALTH AND DISEASE. 



CHAPTER I. 

ELEMENTS OF THE HUMAN BODY. 

The study of .any scientific subject requires for 
its full elucidation the investigation of all colla- 
teral branches that contribute to a clear and lucid 
understanding of it. The materials that go to 
make up the body are therefore first dealt with. 
The human body is composed, chemically speaking, 
of twelve elementary bodies — carbon, hydrogen, 
nitrogen, oxygen, sulphur, phosphorus, calcium, 
chlorine, sodium, magnesium, potassium, and 
iron completes the list. There are other elements 
found in minute traces in the body, but they 
are no doubt accidental. The first four named in 
the above list are in far greater proportions than 
the rest. Now as food and air are the sources 
from which the elements are supplied, it is evident 
that they should contain all the elements named 
in the foregoing list, and upon analysis they are 
all found in the animal and vegetable kingdoms 
of nature, from which man derives his food. Foods 
are derived from both animals and vegetables and 
are therefore classed as animal and vegetable foods. 



2 CARE OF THE BODY IN HEALTH AND DISEASE. 

A more scientific classification is into proteids or 
albuminates, hydrocarbons or fats, the carbohy- 
drates and the mineral salts including water. The 
proteids embrace the various albumens, the leans 
of meats and various other principles allied to 
them. The hydrocarbons embrace all the fats, 
and oils, whether of animal or vegetable origin. 
The carbohydrates include all forms of starches 
and sugars. The mineral is made up of sodium, 
potassium, calcium, phosphorus and sulphur, in 
the forms chiefly of chlorides, and phosphates, 
water is also classed with the mineral. 

The reader will remember that these four classes 
of food stuffs are absolutely necessary for the 
healthy maintenance of the body. Some foods 
contain all of them. Milk for example is a com- 
plete food, and the little child can therefore thrive 
on it alone for the first year or two of its existence, 
but for adults it is not a suitable food alone. The 
reason is that it is too bulky for the amount of 
nourishment it contains. The elements named 
already are in abundance all around us, but before 
they can be assimulated, they have to be converted 
into very complex forms; such as are found in the 
ox, the pig and cereals of plants as wheat and 
maize or corn. The ox feeds on grass and converts 
it into more complex substances suitable for the 
food of man, whereas the grass feeds on the inor- 
ganic kingdom and makes a suitable food for the 
ox. Thus in considering the origin of food we learn 
how the simplest vegetable forms grow and feed 
on the constituents of the atmosphere as well as 
of the soil. The ox nor the sheep cannot do this. 
The animal unable to construct organic matter 



ELEMENTS OF THE HUMAN BODY 3 

from the inorganic is dependent upon the vegeta- 
ble world for his food, and man in turn is depend- 
ent upon the animal for some of his most important 
food stuffs. It might be said that plants pass their 
lives in preparing food for the animal, and the ani- 
mal passes his life in preparing food for man. I 
will now consider food stuffs from a special stand- 
point. 

Animal foods embrace such as the flesh of ani- 
mals, milk, butter and eggs, and are exceed- 
ingly well adapted to minister to the growth and 
maintenance of the body. Some of the more im- 
portant of them are beef, mutton, pork and bacon, 
fowl and game. Beef is an exceedingly valuable 
food and is best from the ox slaughtered at from 
three to five years of age. The digestibility of 
beef is inferior to mutton, and pork and bacon are 
less digestible than either of those named. I 
might quote from Professor Harrington's practi- 
cal hygiene, the characteristics of good meats. 

Meat should have an even uniform color. Nei- 
ther abnormally pale nor inclined to purplish. It 
should have little or no odor, and such as it has 
should give no disagreeable impression, such as 
the sickly cadaveric smell, characteristic of dis- 
eased or decomposed flesh. It should be firm and 
elastic and should not pit nor crackle on pressure. 
On being handled it should scarcely moisten the 
fingers, and with keeping the exterior should be- 
come dry rather than wet. There should be no 
evidence whatever of the presence of parasites. 
Beef has a bright red color and a marbled appear- 
ance due to the presence of fat between the bun- 
dles of muscular fibres. This marbling is much 



4 CARE OF THE BODY IN HEALTH AND DISEASE. 

less apparent in the flesh of animals that have not 
been well fed, and of old cows and bulls. 

Bull meat is darker than that of oxen and cows, 
and is coarse, stringy and of strong flavor. Veal 
is much paler than beef and less firm to the touch, 
and coming from a very young animal 'Bob-Veal,' 
it is flabby and watery and its fat has a tallowy ap- 
pearance. Mutton should be of a dull red color 
and firm to the touch. Its fat is white; sometimes 
yellowish and hard. Lamb is somewhat less firm 
to the touch and has a decidedly lighter color than 
mutton. Pork is much less firm to the touch than 
beef and mutton, and its fat is quite soft in com- 
parison. Horse meat, the use of which is increas- 
ing rapidly abroad and to a much greater extent 
in this country, than is commonly believed, is 
darker and coarser than beef, and possesses a very 
different odor. The fat is yellow and oily and has 
a rather disagreeable odor. The flesh of birds is 
not marbled like that of an animal. That of wild 
fowl that feed on fish has a strong flavor which is 
not improved by keeping. 

The cooking of food, especially that of meats, is 
a very important thing. In boiling, in order that 
the meat should retain its flavors the meat should 
be dropped into boiling water and allowed to boil 
for five or ten minutes, and the heat partially with- 
drawn so as to bring it below the boiling point, 
and kept at about a hundred and eighty degrees, 
fahrenheitthermometor, until the meat is thoroughly 
done. Cooked in this w^ay the meat will be tender, 
as well as to retain its flavors. Whereas if the 
temperature be kept at a boiling point until the 
meat is cooked the meat will be tough and hard. 



ELEMENTS OF THE HUMAN BODY- 5 

If the meat be placed in cold water and the tem- 
perature gradually raised to the boiling point the 
meat loses its chief flavor, but however, if one 
wishes to make a good broth the latter method is 
the one. 

In roasting, the meat should be placed in very 
hot lard; the temperature being kept high for five 
or ten minutes, and then partially withdrawn. 
The meat then will retain its flavors and be soft. 

As to the frying methods I judge most people 
know enough of them. As they are not the best 
methods of cooking meats, I will say nothing on 
them. 

Meats are sometimes infected with germs and 
parasites when otherwise in good condition. The 
most efficient method of their destruction is by 
thorough cooking. Persons have not unfrequently 
been infected with Trichinaspiralis by eating un- 
cooked meat, producing a disease that very gener- 
ally proves fatal. 

Milk being a very important food, requires con- 
siderable care in keeping. Perfect cleanliness 
should be observed in milking, and it should be 
kept in a cool place and where there are no ill odors, 
as it very readily absorbs any foul odors. 

Butter also will absorb foul odors in the same 
way. 

Only the more important points connected with 
food stuffs can be dealt with in this place. 

We derive from the vegetable kingdom a great 
variety of foods; many of them of a highly nutri- 
tious character. Unlike what is generally sup- 
posed, vegetable foods are less digestible than ani- 
mal food, and there is more waste product from 



6 CARE OF THE BODY IN HEALTH AND DISEASE. 

them than there is from animal food. Some of 
the more important of the vegetable foods are 
wheat, maize, rye, oats, beans, peas and lentils. 
All those named have a great deal of starch in them ; 
some of them small traces of fat. Wheat is prob- 
ably one of the most important vegetable cereals; 
being largely used for breadstuffs; also corn, rye 
and oats are used extensively as foods. The roots 
and tubers as potatoes and arrow-root are also 
valuable forms of food, but less nutritious than 
any of those above named. 

A great variety of fruits both in the fresh and 
dried state are used as articles of food and flavor- 
ing luxuries. The following are some of the prin- 
cipal varieties made use of; 

Apples, peaches, pears, oranges, lemons, limes, 
plums, apricots, cherries, olives and dates. 

The apple when cooked is easy of digestion, cool- 
ing and slightly laxative. Pears of good quality 
when ripe are better suited for eating raw than 
apples. Oranges are especially valuable for inva- 
lids, they are pleasant and refreshing and very 
grateful in feverish conditions. The lemon and 
lime are important as yielding a useful antiscorbu- 
tic juice. The grape is a very important fruit on 
account of its richness in sugar. It is very digesti- 
ble when ripe, and acceptable to invalids. 



BEVERAGES. 



CHAPTER II. 

BEVERAGES. 

All beverages contain water and as may be seen 
by reference to the various analysis of the solid 
foods water enters largely into their composition. 
The body itself contains about seventy per cent, 
of water. 

Everything that is carried into the circulating 
fluids of the body or eliminated from them is con- 
veyed by the agency of water. As a solvent it is 
indispensable in all functional activities. The 
consumption of a certain amount of water is abso- 
lutely necessary. Considerable amount of this is 
taken into the body combined with the solids of 
the food ; but a certain quantity is required in fluid 
form, and this is supplied by beverages. 

One of the best ways of supplying water to the 
body is by drinking it in its pure state. Its sol- 
vent properties can then be completely utilized. 

The purer water obtained for drinking purposes 
which is from wells, springs, rivers and rain- 
water, contains mineral ingredients in solution. 
It is highly needful to insist on the importance 
which is now generally recognized, that the water 
we use for drinking purposes is free from all organic 
impurity. The minerals in otherwise pure drink- 
ing water are not often in sufficient quantity, or 
of a nature to be harmful for drinking purposes. 
This subject will be treated of further on. 



5 CARE OF THE BODY IN HEALTH AND DISEASE. 

As tea and coffee are so extensively used as bev- 
erages we might here notice them. Although they 
differ considerably from one and another in their 
physical character, they agree in containing prin- 
ciples, which are either identical or closely related. 
There is a considerable resemblance in the general 
affects of tea and coffee, as might be concluded, 
from the fact that they contain the same active 
principle. While the different aromatic princi- 
ples, or essential oils they contain, and to the as- 
tringency of the tannin the tea contains. 

The difference between green and black tea is 
simply dependent upon the difference of the time 
of gathering the leaves, and their mode of treat- 
ment. The green is prepared from the younger 
leaves and roasted soon after gathering. 

As to the effects of tea as an article of diet, con- 
siderable difference of opinion exists, and espec- 
ially as to the relative value of tea and coffee It 
should be recognized that there often exist individ- 
ual peculiarities with regard to these beverages, 
and hence the conflict on this point 

Tea removes fatigue, clears the mind and pro- 
motes intellectual energy. Tike coffee, it has a 
tendency to diminish sleep when taken warm as it 
usually is; no doubt the warmth aids the stimula- 
ting influence. It increases the action of the skin 
and has been credited with producing constipation, 
which it no doubt does in many persons, owing to 
the tannin it contains 

There can be no doubt that when tea is used to 
excess that it is harmful to many persons 

Coffee is also an agreeable aromatic prepared 
from the seeds after they have been roasted The 



BEVERAGES. 9 

Mocha and Arabian coffee is considered the best. 
The effects of coffee are those of a decided stimu- 
lant to the nervous system on account of its stimu- 
lating action on the brain. It lessons the need 
for sleep after exertion. It also diminishes the 
sense of fatigue. It has a decided stimulating 
effect on the heart, but in large quantities it usu- 
ally slows the action of the heart When taken in 
excessive amount it will disturb the rhythm of 
this organ in many persons. It increases the elim- 
ination by the kidneys of the urine; also it increases 
the secretion of the skin. It sometimes disturbs 
digestion and gives rise to heartburn, and this is 
said to occur in persons who take it very strong 
just after meals. 

In support of the value of coffee I might quote a 
few words from Yeo's Manual of Food in Health 
and Disease. "Although coffee can exert no di- 
rect nutritive action in the system, and it has been 
shown that its use tends to increase rather than 
diminish the excretion of urea, yet its influence in 
sustaining the human body under fatigue and pri- 
vation is very remarkable. Parks bears strong 
testimony to its great value in the diet of the sol- 
dier. ' Not only is it invigorating without produc- 
ing subsequent collapse, but the hot infusion is al- 
most equally serviceable against both cold and heat. 
In the one case the warmth of the infusion, in the 
other the action on the skin being useful, while in 
both cases the nervous stimulation is very desir- 
able.' It has been said to afford some protection 
against malaria. When coffee is taken as it usu- 
ally is, together with milk and sugar, it then con- 
tains a considerable amount of nutritive substances 



IO CARE OF THE BODY IN HEALTH AND DISEASE. 

and forms a highly sustaining food. The valuable 
properties possessed by coffee are occasionally 
utilized in the treatment of disease, as an antidote 
for instance in opium poisoning or alcoholic intoxi- 
cation. It is also given as a cardiac tonic in heart 
disease and as a diuretic in dropsy and urinary 
disorders. " 

ALCOHOLIC BEVERAGES. 

Alcoholic beverages embrace whiskey, brandy, 
the various kinds of wines, champaigne, ale and 
beer are the chief of the beverages named. All 
these beverages are made by firmentation. Their 
intoxicating strengths are all owing to the per cent, 
of alcohol they contain. It is unnecessary in this 
place to describe the process of the making of them, 
as it would consume altogether too much space. 
They have been in use from very ancient times. 
It appears that wine was known soon after the 
flood, and beer was known to the Egyptians over 
four thousand years ago, and was largely used by 
the soldiers in the campaigns of Caeser. 

The effects of alcoholic beverages have been 
written upon extensively. It appears to be a dif- 
ficult matter to decide whether alcohol is a true 
food or not. This depends upon the meaning at- 
tached to the word food. There is no doubt that 
part of the alcohol taken into the system is oxidized, 
but it is quite a doubtful matter if any of it is con- 
verted into the tissues of the body. Its stimula- 
ting effect is well known, and depends largely upon 
the amount taken. In small quantities by stimu- 
lating the secretion of the gastric juice it increases 
the appetite, but in large quantities it has the op- 



BEVERAGES. II 

posite effect and arrests digestion. Small quanti- 
ties exalt the feelings and large quantities depress 
them. It is most important that we remember 
that the effects of alcohol vary greatly in different 
individuals, and that what may be sufficient to 
produce a pleasant effect in one person will intoxi- 
cate another. 

Indeed it is mainly on account of the remark- 
able difference in its effects on different individuals 
that so much misunderstanding exists as to its char- 
acter. 

Some strong advocates of the use of alcohol in 
disease regard it as a useful food if taken in mod- 
erate doses. 

Experiments would seem to sh)w that for a 
healthy adult individual that one ounce of brandy 
or whiskey is a sufficient dose for one time, and 
that should not be repeated under six or eight 
hours. This is meant of course to only be given 
in emergencies. 

Women are more easily effected by it than men, 
and persons of a nervous temperament than the 
robust. I might here quote from Yeo's Manual 
of food in health and disease. "That alcohol taken 
in small quantities improves the appetite and bene- 
ficially increases circulatory activity is almost 
universally admitted. Of its value as a sedative 
to the nervous system in certain diseased condi- 
tions there is also nearly a general acknowledg- 
ment, as to its influence on the work of the body, 
physical and mental, it would seem, when taken 
in the moderate quantity above stated, to be health- 
ful under many circumstances. Taken in larger 
quantity on the contrary to be almost invariably 



12 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

harmful. Women seem more susceptible of its 
injurious effects and should take it with even more 
moderation than men, and healthy children should 
do without it altogether. Alcohol taken in excess 
is known to lead to very serious morbid changes in 
nearly all the organs of the body. Chronic inflam- 
matory and degenerative changes of a granular 
fibroid and fatty nature attack the stomach, liver, 
lungs, kidneys, the brain and its membranes, and 
especially the blood vessels." 

In regard to the influence of alcoholic beverages 
on digestion some authorities claim that when used 
in small quantities about meals that they aid diges- 
tion. My impression is that in most persons that 
would be merely temporary that if they are con- 
tinued for any great length of time they are apt to 
impair digestion. There can be no doubt that 
healthy persons are better off without them than 
with them. In treating on alcohol as a medicine, 
I will say more on this point. 

As to the strength or the per cent, of alcohol in 
the various beverages, those oi the weaker kind 
are less likely to do harm than the stronger ones. 

Brandy and whiskey have from forty to fifty 
per cent, alcohol. Usually wine has from five to 
ten per cent, alcohol. Beer from two to five per 
cent, and champaigne from ten to twenty per cent. 

Whiskey and brandy when new always have 
fusel oil in them, or amilic alcohol, which is grad- 
ually changed by age and gives flavor to the spirits. 
But it is two or three years before the changes take 
place. For that reason whiskey or brandy when 
new ought not to be used. The fusel oil has a poi- 
sonous effect, All the spirits, those that are dis- 



BEVERAGES. - 13 

tilled and those that are not, are often adulterated 
with various drugs, and of course are not fit for 
use. 

CONDIMENTS. 

Condiments are used for the purpose of flavor- 
ing and exciting appetite, and to promote digestion. 
They greatly increase the pleasures of eating; they 
stimulate the digestive juices, and some of them 
are distinctly antiseptic. The must important 
and most extensively used is common salt. Com- 
mon salt is useful in several ways. It is necessary 
to the tissues of the body; it is found in all the tis- 
sues; it breaks up to help form the acids of the 
stomach, and is a powerful antiseptic, and is a good 
diuretic. Also it is used extensively to preserve 
meats. 

Vinegar is also a very important condiment ex- 
tensively used to give flavor to many articles of 
food. It is also highly antiseptic. It stimulates 
the appetite and promotes digestion. 

Peppers and spices, cloves, mint, thyme, fennel, 
and sage are all condiments that are to some ex- 
tent useful in stimulating the appetite and diges- 
tion. 

THE PREPARATION OF FOOD FOR EATING. 

In very ancient times many nations eat their 
foods raw; their cereals, wheat and maize and other 
grains, and at the present day some persons eat 
their meats raw, but there can be no doubt that 
with a few exceptions, foods should be cooked be- 
fore being eaten. 

Milk is rendered more indigestible by being 



14 CARE OF THE BODY IN HEALTH AND DISEASE. 

cooked and is not as palatable. Some articles of 
food are better half cooked. Eggs are much more 
digestible half done than well cooked. 

Cabbage is more digestible hardly done than 
thoroughly cooked. With those exceptions boil- 
ing and roasting and baking should be thorough. 

The cooking of foods greatly improves their fla- 
vors; especially animal foods, and renders them 
pleasant to the palate. In the next place it ren- 
ders food more easily masticated, and contrary to 
the opinion of many, it renders them more easy of 
digestion. 

It has become an almost universal custom in 
civilized life to have a fixed time of day for taking 
meals. In some countries some classes of persons 
eat four times a day; some three times, and others 
only twice. In fixing the intervals which should 
occur between meals it is necessary to bear in mind 
that digestion varies considerably in different per- 
sons, and is influenced by occupation. It usually 
requires from three to four hours in a healthy man 
to digest an ordinary meal. In growing persons 
and children digestion goes on faster than in ma- 
ture age. The first meal of the day is breakfast. 
In case of active persons of regular lives should be 
taken as soon after rising as possible. It has been 
said persons who have to take exercise before 
breakfast are either dyspeptic or overfed. The 
unfed person at this period of the day is said to be 
more subject to the influences, and especially prone 
to take harm from exposure to cold. It is impos- 
sible to lay down any definite rules to guide all 
individuals in their methods of taking food. Three 
times a day seems to me a very appropriate way 



BEVERAGES, 1 5 

of taking meals. A habit of eating between meals 
is harmful to digestion, as it disturbs the stomach 
in its operations. 



1 6 CARE OF THE BODY IN HEALTH AND DISEASE 



CHAPTER HI. 

FOOD IN RELATION TO AGE AND CONDITION. 

In considering the proper relations between the 
anuunt of the food taken and the age of the in- 
dividual and the conditions under which he is liv- 
ing, we have to bear in mind that there are three 
periods after the sucking period that require spec- 
ial attention. 

The age of growth, the period of adult life and 
that of old age. In the age of growth food is not 
only used for repair but for growth also, and for 
that reason growing persons should have a greater 
allowance in proportion to size than the adult. In 
children a great deal of care is necessary that the 
food be light and properly prepared; otherwise 
they often become dyspeptic. Especially they 
should have a light supper. 

In the adult the amount required is very vari- 
able, owing to the various occupations and habits 
and conditions of the people. It might be said 
that the appetite if it has not been perverted, and 
is not influenced by disease, is a fair guide. 

In regard to food in advanced age I will here 
quote from Yeo's Manual of Food in Health and 
Disease. "With advancing years the functional 
activity of the bodily organs diminishes. The 
capacity for physical exertion is considerably 
weakened, and the mental powers usually begin 
to flag. The functional activity in the digestive 



FOOD IN RELATION TO AGE AND CONDITION. 1 7 

organs partakes in this general decline; so that 
while there is less need for food on account of low- 
ered physical and mental activities, there is also 
less power of digesting and assimilating food on 
account of the s^wly progressing degenerative 
changes in the secreting glands, and the consequent 
diminished digestive and absorbant power in the 
alimentary canal. The circulation through the 
abdominal organs also tends to become languid, 
so that absorption is thereby delayed and may be 
further hindered by degenerative changes in the 
blood vessels themselves. 

Moreover the muscular walls of the intestine 
lose their tone and contractive power, there is a 
tendency tJ dilatation, especially of parts of the 
large intestine, causing delay in the expulsion of 
the residual feces, so that constipation and flatu- 
lence tend to add further to the embarrassment 
of the digestive function. All these inevitable 
changes necessitate appropriate and correspond- 
ing changes in the amount and kind of food taken. 
In the first p^ace the food must be diminished in 
quantity as the increase -in age. Says Sir Henry 
Thompson, less energy and activity remain and 
less expenditure can be made. Less power to 
eliminate is possible at fifty than at thirty, still 
less at sixty and upwards. Less nutriment must 
therefore be taken in proportion as the age ad- 
vances; or rather as activity diminishes or the in- 
dividual will suffer. If he continues to consume 
the same abundant breakfast, substantial lunches 
and heavy dinners, which at the summit of his 
power he could dispose of almost with impunity 
he will in time certainly either accumulate fat or 



1 8 CARE OF THE BODY IN HEALTH AND DISEASE. 

become acquainted with gout or rheumatism, or 
show signs of unhealthy deposits of some kind in 
some part of the body, Processes which must 
inevitably empoison, undermine or shorten his 
remaining term of life. He must reduce his intake 
because a smaller expenditure is an enforced con- 
dition of existence. At seventy the man's power 
has further diminished, and the nutriment must 
correspond thereto, if he desires still another 
term of comfortable life. And why should he not? 
Then at eighty with less activity there must be 
still less support, and on this principle he will yet 
long continue.' And in another work Sir Henry 
again comments aptly on this subject. * It is ab- 
solutely certain contrary to the popular belief that 
while a good supply of food is essential during the 
period of growth and active middle life, a dimin- 
ished supply is desirable in relation to health and 
prolongation of life during declining years. When 
physical exertion is small and the digestive faculty 
becomes less powerful also. The system of sup- 
porting aged persons as it is termed with increased 
quantities of food and stimulants is an error of 
cardinal importance, and without doubt tends to 
shorten or to imbitter life. As age increases the 
ability to eliminate food unnecessarily consumed 
notably diminishes. The elderly man who desires 
to preserve fair health and to retain the longevity 
should gradually diminish his use of strong nitro- 
genous and much fatty food.' 

In Prof. Humphrey's report on centenarians 
published in the reports of the collective investiga- 
tion committee of the British Medical Association 
it appears that in their habits in the matter of eat- 



FOOD IN RELATION TO AGE AND CONDITION, 19 

ing and drinking tended as a rule to great modera- 
tion in both. The large majority were small or 
moderate eaters. Of animal food the majority 
took but little. Of thirty-seven, three took none, 
four took very little, twenty took little, ten took 
a moderate amount and one only, took much. 
The exact quantity is mentioned in nine instances. 
One took twelve ounces, one six ounces, one five, 
and six took four ounces daily. In the use of alco- 
holic drinks we also find evidence of great modera- 
tion. Fifteen were either all their lives or in their 
old age or youth total abstainers. Twenty-two 
took but little; two very little; ten a moderate 
amount of alcohol, and some who had taken a little 
alcohol formerly were taking none in their old age. 
It is remarkable how numerous in the published 
records of centenarians are the references to the 
great sobriety, temperance and abstemious habits 
of the immense majority of persons w T ho have 
reached great age; and especially frequent is the 
statement that they have partaken very sparingly 
of animal food. " 

Men of eighty or ninety years should exercise 
considerable caution in making any very decided 
change. Any change in the quantity of food taken 
should be made gradually. The proportion of ani- 
mal to vegetable food should not exceed more than 
one of the former to three of the latter. It is con- 
sidered best at this period of life that the time of 
taking food should be oftener, and some authori- 
ties think that they should be fed during the night 
of food in the fluid form. They often rest better 
by doing so. 



20 CARE OF THE BODY IN HEAI/fH AND DISEASE. 
FOOD IN DISORDERS OF DIGESTION. 

In diseases of the digestive organs which are 
concerned in digestion and assimilation of food 
must necessarily and especially be under the influ- 
ence of dietetic treatment. The subject of the 
dietetic treatment of diseases of the organs of di- 
gestion is quite a difficult one as it involves some 
obscure and disputed points about digestion, and 
is associated with controversial questions in which 
the general public take prominent interest. 

I here cannot do better than quote from Yeo's 
Manual of Food in Health and Disease concerning 
acute gastric catarrh which is often called dyspep- 
sia or acute indigestion. He says — "Acute Gas- 
tric Catarrh is a common disease, and is caused 
usually by the action of improper and irritating 
food on the gastric mucuous membrane. Any 
local irritant may of course excite inflammation of 
this membrane if brought in contact with it, and 
acute gastric catarrh is an almost invariable ac- 
companiment of irritant poisoning; but the com- 
mon and familiar forms of this disease are most 
frequently the result of improper feeding. Some 
persons are however much more predisposed to 
suffer from this disease from comparatively slight 
causes than others. It has been pointed out that 
too scanty a secretion of gastric juice by retarding 
digestion and favoring abnormal decomposition of 
food within the stomach predisposes to this malady. 
Hence it is necessary in febrile states when owing 
to the high temperature there is much loss of fluid 
from skin and lungs, and therefore diminish secre- 
tion of gastric juice, to diminish accordingly the 



FOOD IN RELATION TO AGE) AND CONDITION. 2T 

quantity of food. The common custom of urging 
such patients to take more nourishment than they 
wish is often injurious, unwise and unphysiological. 
Anemic and feeble persons generally and convales- 
cents from acute disease are also liable to attacks 
of acute gastric catarrh from taking more food and 
a small amount or the altered less active character 
of their gastric juice is capable of dealing with, 
that some of the undissolved ingesta decompose 
and set up irritation of the gastric mucous mem- 
brane. It is indeed most important to bear in 
mind that the over-anxiety manifested by the 
friends of such patients that they should take large 
quantities of food in order to quickly recover their 
strength has often the opposite effect to the one 
desired. Overloading the stomach with food in 
healthy persons is a common cause of acute gastric 
catarrh owing to the abnormal decomposition 
which the excess of ingesta undergoes. This is a 
frequent cause of gastric catarrh in young children 
and especially children at the breast who are al- 
lowed for the sake of quiet to suck until they have 
overloaded their stomachs. Imperfect mastica- 
tion also may give rise to gastric catarrh as the 
food then reaches the stomach in a comparatively 
undivided state, so that the gastric juice comes 
into very imperfect contact with it, and hence por- 
tions remain undissolved and undergo decomposi- 
tion. 

Rich and fat sauces and too much fat eaten with 
meat may lead to the same result. By covering 
or soaking the meat with an oily fluid which pre- 
vents the gastric juice from thoroughly penetra- 
ting it. 



2 2 CAR£ OF THE BODY IN HEAI/fH AND DISEASE. 

Food eaten when it is already in a state of de- 
composition may similarly give rise to gastric ca- 
tarrh and this is especially noticable to delicate 
and sensitive persons. 

Game or fish kept too long and entrees made 
with meats that are not perfectly fresh, sour beer 
and wine, and in young children milk that is not 
quite fresh are fruitful sources of gastric catarrh. 
Too free use of spices and stimulating condiments, 
but especially the habit of taking alcohol in a concen- 
trated form with respect to food is to so limit it in 
quantity and quality that the acutely inflamed 
muc >us membrane shall be spared all irritation or 
excitement from ingesta and the whole organ so far as 
is possible be put in a condition of physiological 
rest. Entire abstinence from food, at least from 
the mouth may often be enforced with advan- 
tage for a day or two; or so long as the taking of 
food excites nausea, vomiting or severe pain. This 
abstinence is usually well borne except in cases 
where the strength has been exhausted by a pre- 
vious suffering and long inability to digest a suffi- 
cient quantity of food. In such cases nutriment 
enemata may for a time be given so as to secure 
the rest needed by the irritated gastric mucous 
membrane, while small quantities of ice water may 
from time to time be taken into the stomach. 

When we restrict patients to liquid food it is 
best to give it in small quantities at short intervals ; 
and when there is much thirst it is better to allow 
small pieces of ice to be sucked than to permit 
large draughts of cold water. In many of the less 
severe cases while still adhering to a fluid dietary 
we may provide the patient with a certain variety 



FOOD IN RELATION TO AGE AND CONDITION. 23 

of food. When milk is well borne either pure or 
diluted, raw or boiled, it forms the most convenient 
and nourishing basis of our dietary, but we may 
prescribe chicken or mutton broth with the ex- 
press juice of vegetables boiled in it." 

The chronic form of this disease is often a sequel 
of the acute affection. Its causes are chiefly the 
same, errors in diet, the use of alcoholic beverages 
which in some individuals of a weak nervous or- 
ganization predispose to the chronic variety of the 
disease. 

The dietetic treatment of this disease is to put 
the patient on a light diet. Milk in some instances 
disagrees. In fact too large a quantity of any 
fluid food will disagree with a dyspeptic. A small 
amount of solid food that has been properly pre- 
pared with milk and broth will agree better in 
chrjnic cases than an absolute fluid diet. Well 
cooked vegetables in moderate quantities changed 
from day to day or meal to meal suit many patients 
very well, combined with light meats, like mutton, 
fat chicken and game. A person should eat slow 
and chew his vituals well. His habits of life should 
be as cheerful as possible for anything that de- 
presses the nervous system is decidedly against a 
dyspeptic. He often gets into a habit of using 
drugs from his own prescription, and many times 
they are detrimental to him, In regard to that, 
it would be best to consult an enlightened physi- 
cian. 



24 CARE OF THE BODY IN HEALTH AND DISEASE. 

CHAPTER IV. 

AIR. 

Air is a colorless and nearly odorless mixture of 
oxygen, nitrogen, argon, carbonic acid, aqueous 
vapor and traces of other substances. It was once 
thought to be an element until about one hundred 
years ago it was shown to be composed of about 
twenty parts of oxygen, to seventy-eight parts of 
nitrogen — not in chemical composition but as a 
mixture. Ten or fifteen years ago another element 
was found in it called argon. There is hardly one 
per cent, in any air samples yet examined. The 
most important ingredient is oxygen, which is the 
great life giver to all animals, and it is very remark- 
able to find it so uniformly defused all around the 
globe — and even in large cities where vast amounts 
of it are consumed it is rapidty replaced. The 
only danger we have to fear for want of it is in con- 
fined spaces without sufficient ventilation. Aque- 
ous vapor is a normal constituent of the air. The 
quantity in the air varies greatly and is influenced 
by the temperature mostly — the higher the tem- 
perature the greater the capacity of the air to hold 
vapor, and when the air takes up all that it is ca- 
pable of holding without being condensed into a 
fog it is then called saturated. The air is never 
completely free from it — in other words dry air is 
only of artificial production. 

It exerts a very important influence. By day 
it absorbs part of the sun's heat and tempers the 



AIR. 2 5 

air. At night it acts as a protector to the earth by 
preventing too great a loss of heat by radiation. 
In countries where there is a very dry air, as in the 
desert of Sahara, after the hottest days the nights 
are very cool, falling forty or fifty degrees C. scale, 
so that it is evident that if there were no aqueous 
vapor at night the earth would lose heat so rapidly 
as to freeze in the summer time in warm climates. 

Dust and microorganisms are associated with 
aqueous vapor in the air. They too are every- 
where except out in mid-ocean there is organic 
and mineral dust and it has its origin from particles 
of matter that rise from the earth. Micro-organ- 
isms are abundant in inhabited rooms and in large 
cities the air is swarming with them — to a less ex- 
tent in the country. Many of them are harmless 
but there can be no doubt that the air is the great 
carrier of disease producing micro-organisms. 

Experiments have shown that at great heights 
the air is free from them. Media for breeding or- 
ganisms have been exposed at a height of eight 
thousand feet above the surface of the earth with 
a negative result. Also the same experiments 
hundreds of miles on the ocean prove the same. 

As stated before, the air is a carrier of micro- 
organisms. It has been found that the bacillus of 
tuberculosis is in an active state in the dust of a 
room a year after the death of its occupant from 
the disease. Their presence have often been dem- 
onstrated in the air of hospitals for tuberculosis, 
and in private houses inhabited by phthisical per- 
sons, and by exposing the dust of rooms inhabited 
by phthisical patients to susceptible animals the 
disease has been produced in those animals. 



26 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

Many of the pathogenic organisms have been 
found in the air. In regard to the organism of 
typhoid fever there are two views as to the mode 
of introduction into the human body, supported 
on either side by able authority. There are a 
large class of eminent physicians hold that the air 
does not carry the bacillus of typhoid; that the 
sole method of introduction is by water and food. 
On the other hand, many equally as eminent hold 
that the air carries the organism that produces 
the disease. I am satisfied from experience in 
practice that the organism is carried by the air. 

In practice in a very mountainous district through 
which railroads were being built I have seen a 
large number of cases, the diagnosis of which v/as 
made clear, and on investigation the water was 
found to come out from under the mountains un- 
inhabited and uninhabitable in many places, and 
there could have been no possible chance of pollu- 
tion of the water by the typhoid bacillus. I also 
am satisfied that the water may be polluted and 
the germs conveyed to persons in that way. 

There is positive evidence that the bacillus of 
diphtheria is conveyed by the air. The organism 
that produces pneumonia is evidently conveyed by 
the air. There is reason to believe that the organ- 
ism that produces cerebro -spinal meningitis is con- 
veyed by the air. Respecting the influence of 
fog, which is prevalent in some districts more than 
others, mostly in low countries or gorges of moun- 
tains, but not unfrequently on the highest moun- 
tains, and in large cities sometimes is a visitant for 
weeks. I cannot do better than quote Professor 
Harrington in his Practical Hygiene, 



AIR, 27 

44 Dust and moisture together in the form of fog 
affect the health of large communities in a marked 
degree. In a still air nearly or completely saturated 
particles of dust and soot to become a nucleus of a 
minute droplet of condensed moisture. These 
countless droplets in a state of suspension form a 
more or less dense blanket of fog which impedes 
dispersion of the impurities given off by natural 
processes and as products of combusion. While 
ordinary country and seashore fogs are not known 
to exert deleterious effects. In smoky cities like 
London the case is quite different. It is a well 
recognized fact that during periods of heavy fogs 
in manufacturing centers the morbidity and mor- 
tality from respiratory disease are increased very 
greatly; and that as the atmosphere clears a sharp 
decline follows. 

In London for example, the usual death rate — 
from all cause? has been known almost doubled 
during a fortnight of continued dense smoky fog, 
and then to return to its normal figure with the 
advent of clear weather. The increase being due 
particularly to bronchitis and other affections of 
the respiratory tract attributed to the finely di- 
vided particles of soot and the acid which accom- 
pany them. During the prevalence of thick fog, 
the air being necessarily in a stagnant condition it 
has been observed that the carbon-dioxide content 
increases progressively. During one such period 
following bright weather the air of London ac- 
quired in four days, three and a half times its nor- 
mal content of this gas." 

In malarial regions there is a great deal of proof 
to substantiate the fact that the germs of malaria 



28 CARE OF THE BODY IN HEALTH AND DISEASE. 

are in the fog, and persons exposed to those fogs 
often have the disease when others living in the 
same houses who are not exposed to the fogs es- 
cape the disease. 

soil. 

Many experiments go to prove that the soil con- 
tains organism in great abundance. Not only 
those of an innocent character but disease producers, 
and from examination of many samples it appears 
that rich soil have vastly more than poor soil. And 
this is borne out by the clinical fact that wealthy 
landed countries have greatly more sickness than 
poor landed countries. It would appear from ex- 
periments made with shallow soil, or the crust of 
the earth, and that from a depth, that pathogenic 
organisms cannot live at a great depth. However, 
they are only found near the top of the ground. 
A few feet down has proven negative in all the ex- 
periments that I have noted of being made, and 
there is reason to believe that the soil is the breed- 
ing place of most pathogenic organisms; and when 
the water is contaminated it is through the medium 
of the soil, and those floating in the air, many, if 
not all of them are vaporized with the aqueous 
vapor from the earth. 

Respecting pulmonary tuberculosis or consump- 
tion of the lungs as regards the soil or earth, I will 
here quote from Harrington's Practical Hygiene 
the following: 

''There is an undoubted connection between 
this disease and soil dampness, which is most mani- 
fest when one investigates the prevalence of the 
disease over the same soil before and after soil 



AIR. 29 

drainage, by which it will always be found to be 
diminished. Why this is so we can only conjec- 
ture. We know that dampness is one of a possibly 
considerable number of factors in producing pre- 
disposition to the disease. We know that other 
conditions being the same, the disease is far more 
common on low damp soil than on elevated dry 
ones. We know also that the disease is compara- 
tively rare in some parts of the earth where the soil 
is exceptionally dry. The distribution of the dis- 
ease and its relation to soil dampness were first 
brought to public notice by Doctor Henry I. Bo- 
ditch of Boston, at the annual meeting of the Mas- 
sachusettes Medical Society in 1862, who submitted 
investigation, which were in substance, that damp 
reason of proximity of bodies of water is an excit- 
ing cause of consumption; which disease can be 
checked in its course or even prevented by proper 
attention to soil conditions. Shortly afterward 
similar conclusions were promulgated in England 
by Doctor Buchanan, who had been making ob- 
servations along the same line, not knowing that 
Doctor Boditch was similarly engaged. These 
propositions were accepted by the profession and 
have been maintained ever since." 

BACTERIA IN WATER. 

People generally know that even good qualities 
of drinking water a r e swarming with bacteria or 
minute organisms; and no doubt many, should 
they view their drinking water with a microscope 
of high power, would not use their water. For 
the most part these little organisms are harmless; 
and scientific investigators tell us that they serve 



30 CARE OF THE BODY IN HEALTH AND DISEASE. 

an exceedingly useful purpose. It is certain that 
they can be found in all water; both of good quality 
and impure water, but occasionally the water car- 
ries disease producing organisms. There are only 
about two diseases that we have anything like pos- 
itive proof, that are conveyed to persons through 
the medium of the water, and those are asiatic 
cholera and typhoid fever. Of those two diseases 
there is positive proof that the organisms find a 
suitable place to live in water, and of course could 
easily be introduced into the systems of men. 

SPACE REQUIRED FOR GOOD VENTILATION. 

The space required for good ventilation is not 
as well known as it should be. I here below quote 
from Harrington's Pratical Hygiene: 

" If it be agreed that for the most perfect result 
an adult requires a narrowly supply of three thous- 
and cubic feet for the removal of his own effete 
matters, to say nothing of the accessory impurity 
dependent upon illumination, the next question 
is as to the amount of cubic space necessary per 
capita. That is to say — through how small a 
space that amount of air can be drawn hourly, 
without disagreeably perceptible draughts. The 
sensation of draughts is governed very largely by 
the temperature of the moving air, a cold slowly 
moving current being more susceptible than a 
Draughts which are productive of discomfort are 
more dangerous than the ordinary vitiation of the 
air, and therefore complete ventilation with draughts 
is worse than partial ventilation without draughts. 
It has been shown by Pettenkofer that with the 
aid of delicate apparatus and mechanical power, 



AIR. 31 

about twenty-five hundred feet can be passed with- 
out draughts through a space of four hundred and 
twenty-four cubic feet in an hour. That is to 
say — through a room eight feet square and six and 
one half feet high the air can be renewed six times. 
The minimum space within which one can re- 
ceive under artificial conditions six complete changes 
of air in one hour is therefore four hundred and 
twenty-four cubic feet; but in order to get three 
thousand cubic feet in one hour the air would have 
to be changed seven times, and so the required 
minimum space would be five hundred cubic feet. 
In large spaces however, it is possible to obtain 
draughts. Thus in a hall forty by twenty by fif- 
teen feet, forty persons may be supplied with three 
thousand cubic feet each per hour, and each one 
will have three hundred cubic feet of air space. 
Therefore in dealing with large spaces we may as- 
sume three hundred cubic feet per capita rather 
than five hundred. In ventilation of small spaces 
there is in addition to the possibility and danger 
of draught a great difficulty that the inlets and out- 
lets are necessarily so near together that much of 
the air will pass directly from one to the other 
without having mingled with the main body of 
the air, and without therefore doing the slightest 
service in diluting the impurities present. In 
large air spaces this objection does not apply with 
equal force for the opportunity for diffusion is 
greater the larger the space, although of course 
hereto the inlets and the outlets may be so placed 
as to favor the formation of direct currents. In 
the ventilation of large spaces in which large num- 
bers of people gather, as churches, theatres and 



$2 CARE OF THE BODY IN HEALTH AND DISEASE. 

lecture rooms, we are at once confronted by the 
fact that three hundred cubic feet of space is a 
more liberal per capita allowance than is often 
practicable, and that this space is incompatible 
with a draughtless ventilation by the necessary 
air volume. If then the question be asked how 
to provide the necessary amount there is but one 
answer — namely, that it cannot be done. Fortu- 
nately however the danger from impure air is pro- 
portioned to the length of time of exposure an occa- 
sional short time spent in a crowded room or pub- 
lic conveyance filled with bad air being less harmful 
than prolonged and habitual occupancy of a room 
in which the air is less vitiated but not yet good. 

In general it may be said that the importance 
of ventilation varies with particular air spaces. 
Those which are used only at intervals and for 
short periods have much less need of it than those 
which are used uninterruptedly. 

Those which are not crowded demand less than 
those that are. Those used only for the moment 
need no consideration whatever, the natural forces 
at work at all times being sufficient for their needs. 
To insist on thorough ventilation of every part of a 
house at all times as most amateur hyigenists do, 
is to demand a needless waste of energy and money, 
for except in warm months when the windows and 
doors are left freely open for the sake of not only 
ventilation but of general comfort, ventilation 
goes hand in hand with heating and divides the 
expense. Nor can one successfully insist upon any 
rule that each person must have at least a thousand 
cubic feet of air space with renewal of the contained 
air once in twenty minutes ; for to do so is to urge 



AIR. 33 

in the case of the poor of large cities, an impossi- 
bility. 

BATHING. 

The importance of bathing has long been known 
for the removal of dirt and filth and infectious 
matter, and the healthy influence it has on the 
skin being an eliminative organ, and one of nat- 
ural defense. 

Cold baths are those in which the temperature 
of the water is below 65 degrees fahrinheit; cool 
between 65 and 80 degrees. Those between 80 
and 90 are called tepid; and when above 90, up to 
the temperature of the body, they are called warm ; 
and when above the body temperature they are 
called hot; up to as hot as one can bear. 

Cold bathing is stimulant; the vessels of the skin 
contract at once and send the blood inward; the 
perspiration is gasping in character for the moment, 
then slowed and increased in depth. The nervous 
system and all of the mental faculties receive an 
immediate powerful stimulus; the pulse is usually 
slowed. On emerging from the cold water the 
breathing and pulse return to their normal rates. 
The vessels of the skin relax and dilate, and the 
return of blood in increased volume to the surface 
gives a sensation of warmth. This is regarded 
as the normal reaction. 

The proper time for cold bathing is on rising in 
the morning, and should not be taken at night. 
Cold bathing is not safe for persons advanced in 
years in whom the arteries are rigid, nor for those 
with a poor circulation. 

Strong persons it is said, are fortified against 



34 CARE OF THE BODY IN HEALTH AND DISEASE. 

taking cold by cold bathing. In sea bathing the 
element of enjoyment has a most important influ- 
ence; the public attribute good effects to the salts 
in the sea waiter, but it is very doubtful whether 
they have any beneficial action or not. Warm 
bathing causes the opposite effect of cold bathing 
That is they dilate the vessels of the skin and often 
produce sweating. 

The breathing and pulse are increased in fre- 
quency and the effect produced is soothing. Hot 
bathing is a grateful means of reducing soreness 
of the muscles after severe exercise, and is a valu- 
able agent in producing sleep to persons wiio can- 
not rest at night. For purposes of personal clean- 
liness the warm bath is better suited than the cold, 
since it can be endured with comfort very much 
longer, and the relaxation of the skin which it in- 
duces is more favorable for the removal of impur- 
ities. In case complete bathing apparatus are not 
at hand persons in that event may sponge them- 
selves, and with dry towels clean themselves thor- 
oughly. 

PHYSICAL EXERCISE. 

It is quite an essential thing to maintain health, 
that a well nourished body shall be exercised prop- 
erly. The effort of the muscles involved in what 
is designated as Physical Exercise, and in the 
pursuit of certain callings which necessitate exer- 
cise affects not alone the general musculature but 
the organs of the body in general as well as the 
heart, lungs and digestive a/pparatus, skin kidneys, 
brain and in short — all parts of the body. The 
heart and lungs being stimulated to increased 



AIR, 35 

action, a greater blood supply is sent to every part 
of the body, carrying with it essentials to full 
nutrition and conveying to the eliminative channels 
the waste products of the body. The special 
stimuli of the various organs are excited, and the 
several functions are maintained in a normal state 
of activity. 

In order to appreciate the benefits of physical 
exercise we can but compare the rugged condition 
of the well nourished laborer in the fields, or of the 
student or man of business who in the intervals 
away from his work seeks recreation in out-door 
exercise or gymnastics with that of the pentup 
sedentary operative, or the indolent seekers of 
pleasure involving inaction. Whether the work 
of the individual be that of the hand or brain, it is 
sustained better if the system is kept active in all 
its functions and parts. 

I will here quote on the kinds of exercise from 
Professor Harrington's Practical Hygiene: 

" Exercise as a hygienic measure may be divided 
into out-door work including walking, riding and 
athletic sports, and in-door work or systematic 
gymnastic exercises. The former preferred by 
all English speaking people are carried on under 
far more healthy condition and bring with them a 
much greater measure of enjoyment than the 
latter, which are preferred on the continent more 
especially by Swedes and Germans. Indoor work 
in the gymnasium is as a rule purely work without 
the element of pleasure either in anticipation or 
during its continuance, and is performed as a seri- 
ous duty. It is carried out from day to day for a 
longer period if done in company with others, as 



36 CARE OF THE BODY IN HEALTH AND DISEASE. 

in a class; in which case emulation may stand in 
the place of actual enjoyment. But ordinary 
indoor exercise with Indian clubs, dumbbells, 
chess weights and similar appliances carried on 
alone in ones room is usually m )st unsatisfactory 
in its results. There are some doubtless who 
regularly take a certain amount of this class of 
exercise enjoy it and profit by it, but commonly 
the enthusiasm which attains the purchase of the 
appliances decline in a marked degree by the end 
of the third or fourth day of use and have disap- 
peared in a week. Soon the exercise simply a duty 
developes into a bore, for the monotony of this 
kind of work into which no sense of achievment 
enters except that from the accomplishment of a 
wearisome round of strokes measured by hundreds 
produces a distaste, and soon the work becomes 
spasmodic, the intervals growing longer and longer 
and finally is abandoned completely. " 

CIvOTHINCx. 

The matter of clothing being such an important 
one I cannot do better than to quote from the 
author quoted above: 

"The objects of clothing are aside from motives 
of decency, to protect the body from the sun's 
rays in hot weather, from the chilling influence 
of winds in all weathers. From rain and other 
forms of wet, and from mechanical and other 
external injuries and discomforts. To conserve 
the body temperature and to prevent interference 
with the natural functions of the skin, and finally 
to adorn the person. 

The proper fulfillment of these various objects 



air. 37 

is dependent upon the nature of the material, 
the looseness of its texture, its color, its hygroscopic- 
ity and heat conductivity, and its special adapta- 
bility to some particular purpose. The heat of 
the sun's rays is absorbed to the greatest extent 
by black materials and least by white. Next to 
black comes the dark, shades of blue and then in 
order green, red and yellow. Heat is reflected 
most by white and then in order, the light shades 
of yellow, red, green and blue. The color of under- 
garments not exposed to the rays of the sun exer- 
cises no influence whatever. The looser the texture 
the greater the amount of air in the interstices. 
And air being a very poor heat conductor, other 
things being equal, a loosely woven fabric prevents 
loss of body heat in still air more than one of closer 
texture. Thus it is that a thin loosely woven 
garment of woolen is warmer to the body in a still, 
cold atmosphere than an equal amount of closely 
woven material of the same or other kind. The 
same result is attained by wearing a number of 
garments, one over another, so that having layers 
of confined air between they act in the same way 
as double windows on a house. 

The value of furs as conservators of heat is 
largely due to the amount of air retained between 
the individual hairs. Impermeable materials being 
absolutely wind proof and hence permitting no 
natural ventilation through their substance, are 
very warm, but have serious disadvantages, the 
most important of which is the retention of the 
transpired moisture of the body which collects on 
the surface and is absorbed only in part by the 
clothing next thereto. Against rain and cold 



38 CARE OF THE BODY IN HEALTH AND DISEASE. 

winds impermeable materials afford very great 
protection. Winds act in two ways to chill the 
body; by constant removal of the air in contact 
with the body, and warm by reason of contact 
and by hastening evaporation of the moisture 
within the substance of the clothing. 

HEAT-CONDUCTIVITY. 

Materials vary widely in their power of heat 
conduction. Among the textiles, linen and cotton 
are by far the best conductors and wool the poorest; 
but since the conductivity of a garment is governed 
mainly by looseness of texture, it follows that the 
same amount of a good conductor loosely woven 
may be warmer than wool woven very closely, 
but the fabrics made of the best conductors are 
commonly very closely woven, and of wool are of 
varying degrees of looseness. 

HYGROSCOPICITY. 

Fabrics hold moisture in two ways. First by 
retaining it in the interstices between the fibres 
and secondly, by absorbtion directly into the 
substance of the fibres. The moisture held in 
the interstices gives a sensation of dampness of 
wetness, and may be largely removed by pressure 
as in wringing. That absorbed into the fibre may 
be very large in amount without giving any sensa- 
tion of dampness, and it cannot be expelled by 
pressure. The latter is known as hygroscopic 
moisture. 

Materials of animal origin are more hygroscopic 
than those of the vegetable world; and while they 
absorb water readily they part with it more slowly 



air. 39 

by evaporation; thus it happens that a person 
sweating to the same extent and under the same 
general conditions feels less sensation of chill on 
resting from his exercise or work when clothed in 
woolen than when his dress is linen or cotton. In 
the latter instance the moisture is held more largely 
in the interstices and the garment may be distinctly 
wet and it then adheres to the skin which as evap- 
oration proceeds becomes chilled through rapid 
abstraction of the heat required in the process; 
whereas in the former the evaporation is gradual 
and the chilling much less perceptible or unnotic- 
able. But here again a hygroscopic material very 
closely woven may be incapable of holding as much 
moisture without imparting a distinct wetness as 
one of a loosely woven substance of low hygrosco- 
picity. 

MATERIALS. 

The materials employed in the making of cloth- 
ing come mainly from the animal and vegetable 
worlds. From the former are derived the wools 
of various kinds, silk, furs, feathers and down and 
leather. From the latter the principal derivities 
are cotton and flax; and of lesser importance, 
straw, hemp jute, and rubber. Wool of various 
kinds is yielded by a number of different genera 
of animals. That in commonest use and to which 
the name is very generally restricted is derived 
from the sheep. Other kinds include mohair from 
the Angora Goat, Cashmere from the thibet goat, 
camels hair and alpaca from a Cameloid ruminent 
of South America; but the terms mohair, cashmere 
and alpaca commonly refer to cotton and sheep's 



40 CARE OF THE BODY IN HEALTH AND DISEASE. 

wool imitations containing no trace of either of 
these more expensive wools. Under the micro- 
scope the fibres of wool are seen to be cylindrical 
and translucent and covered with small imbricated 
scales which like those of a fish or the feathers of a 
bird, run all in the same direction. They are 
sharpest and smallest and hence more numerous 
in the finest sorts. As many as 2800 and as few T 
as 500 to the inch has been counted respectively 
in the best and very inferior kinds. They give to 
the fibres the tenacity with which they cling to- 
gether when woven and the readiness w T ith which 
when wet and subjected to pressure as rubbing 
or wringing, they mat together and cause shrinking 
of the fabric. Woolen goods being poor conductors 
and containing much enmeshed air are the most 
valuable of all textiles for general purposes in all 
climates, and particularly in those in which abrupt 
and wide changes of temperature occur. In very 
hot climates they are inferior as outer garments 
to cotton and linen, which being better conductors 
and reflectors assist more in keeping the body 
comfortably cool. But for under garments wool 
is much better as a protection against chilling 
after active exercise on account of its hygroscopic 
properties. The vapor from the body is condensed 
and absorbed, and the heat which becomes latent 
when the moisture is vaporized, is set free, and the 
evaporation from the fabric to the external air 
proceeds slowly and without chilling effect observed 
when one sits in clinging wet cotton or linen which 
feels cold in proportion to the rapidity with wilich 
it dries. Woolen fabrics are much subject to 
adulteration w T ith cotton and other cheaper mate- 



AIR. 41 

rials. What are known as flannelettes are very 
commonly made wholly of cotton or with a very 
small percentage of wool. Although the name 
is intended to convey the idea that wool is the sole 
or chief material used. What some are pleased 
to designate sanatary flannel is often largely or 
wholly cotton. Shoddy is a fabric made with 
varying proportions of old raveled woolen and other 
cloths with a minimum of new wool. It has, as 
may be supposed, a much inferior tensile strength 
and less uniformity of texture than woolen of good 
quality. 

silk. 

Silk is the spun fibre produced by a number of 
species of insects, especially the Larvae of the 
bombbycid moths called silk worms. To form 
cocoons or protective coverings when about to 
assume the chrysalis stage. The cocoon in which 
the chrysalis is killed yields an exceedingly fine 
thread. When unwound measures more than two 
miles in length and when spun yields in the neigh- 
borhood of five hundred yards of silk thread. The 
outer part of the cocoon is of inferior quality and 
is known as floss. Silk is very hygroscopic. It 
is a poor conductor and a perfect nonconductor of 
electricity. It has great affinity for anilin and 
other dyes. Under the microscope the fibres 
appear as structureless tubes and show no scales 
or surface markings such as are seen on wool. 
Before being woven into fabrics silk is commonly 
weighted with tin and iron with which it forms 
staple chemical compounds. Weighted silk subjected 
to the action of Bunsen flame parts with its organic 



42 CARE OF THE BODY IN HEALTH AND DISEASE. 

constituent but retains its structural appearance. 
Silk is very subject to adulteration with other 
fibres, and to complete substitution by artifioial 
preparations, One form of artificial silk invented 
in 1884 is made from prepared cotton or wood 
fibre. It possesses a very silky lustre and was 
at first very inflammable and even explosive, being 
practically nitrocellulose, but later the product 
was subjected to chemical process and made harm- 
less. Another form is made from cotton waste 
and is produced much more cheaply. Still another 
form is made from gelatine at an expense of about 
a dollar and fifteen cents per pound, It has a 
low tensile strength but may be employed in the 
mixture with general silk or fine linen or cotton 
thread to make a durable fabric. 

Silk is used chiefly in the manufacture of silks, 
satin, velvet, crape and plush. 

ADULTERATION OF CLOTHING. 

Fabrics are much subject to adulteration by 
admixture of fibres of low r er value, as of cotton or 
shoddy to wool, and by starch and mineral matters 
to give weight. Many of the cheapest cotton 
fabrics are so heavily sized that a single washing 
will convert a stiff apparently close wove piece of 
goods into a worthless, coarse, flimsy material fit 
only for sieves. 

SELECTION OF CLOTHING. 

The properties of the various materials used 
in the manufacture of textiles have already been 
given to some detail; and further consideration 
of underclothing and outer garments beyond a 



air. 43 

word of caution against unnecessary weight of 
clothing and undue constriction of any part of the 
body as therefore unnecessary, In the matter of 
constriction no part of the human body is so 
abused as the foot; especially that of women. 
Boots, shoes and stockings should fit the foot, and 
there should be no such thing as the agony which 
many people suffer as a matter of course, in the 
process of breaking in. The toe should be neither 
pointed nor cut square, and the whole sole should 
follow the natural outline of the foot. The sole 
should project a reasonable distance from the 
upper in order to give firmer support and increase 
protection to the soft parts from contact with 
loose stones and other objects. The heel should 
be low and broad. High heels are worn not for 
corafort in walking, but to increase the height of 
the body and diminish the apparent length of the 
foot. For purposes of successful deception they 
take about equal rank with hair dyes and artificial 
complexions. Their use conduces to weakness of 
the arch atrophy of the muscles of the leg, and a 
variety of other abnormalities. 

The heel of the foot should fit snugly within 
the shoe but the toe should have sufficient room 
for freedom of movement; yet not enough to cause 
chafing and excoreations ; the uppers should fit 
snugly but not too tightly about the ankle and 
over the instep, Otherwise the foot will drive 
forward and cramp the toes," 



44 CARE OF THE BODY IN HEALTH AND DISEASE. 



CHAPTER V. 

BACTERIOLOGY. 

It has only been for twenty-five or thirty years 
that this science has been developing. As the 
name implies, it is the science of minute organisms, 
and is chiefly of interest from the effects that the 
organisms have upon the human body in the pro- 
duction of disease. 

All infectious diseases are undoubtedly produced 
by low organisms, although they have not all been 
clearly demonstrated or made out. The diseases 
in which the organisms have not been found behave 
so nearly like those in which they have been found 
that there can be no doubt that micro-organisms 
are the cause of all infectious diseases. Those 
that have been demonstrated clearly each have 
peculiar life histories different from the others, 
each have different forms from the others, and in most 
instances by injecting them into lower animals 
the disease can be produced in the lower animals 
identical with that of man. They can be cultivated 
on a number of media. Some of them are easily 
cultivated; others with more difficulty. Some 
of them grow well on gelatine; some on beef broth 
or bouillon, and agaragar. I thought it proper 
here to give a short sketch of the characteristics 
of some of the most prominent pathogenic organ- 
isms. 



BACTERIOLOGY. 45 

THE STAPHYLOCOCCUS PYOGENES AUREUS. 

This organism is the organism that produces pus 
or common matter found in abcesses. They are 
round or bug-shaped; they are easily cultivated; 
they stain readily; they grow on a potato luxuri- 
ously; they are nonmotile; they are the most com- 
mon pathogenic organism known to the physician 
or surgeon. 

BACILLUS PYOCYANEUS (BACILLUS OR GREEN PUS 

This bacillus is concerned in the production of 
green pus or blue green pus. It is a delicate rod 
with rounded or pointed ends. It moves actively 
and it does not form spores. It grows readily 
on all artificial media, and gives to some of them 
a bright green color most conspicuous where it is 
in contact with air. 

BACILLUS OF BUBONIC PLAGUE. 

This organism is a short and oval bacillus. It 
stains more readily at the ends than at the center 
and is nonsporeforming, and nonmotile. 

This organism produces a disease with a very 
high rate of mortality and from history is evidently 
the disease that went under the name of Plague 
and Black Death which destroyed millions of people 
in the middle ages, all over the East. 

BACILLUS TUBERCULOSIS. 

This organism is a delicate beaded rod that is 
exceedingly small and hard to kill, and hard to 
stain, and is the organism that causes consumption 
of the lungs which is so destructive to the human 



46 CARE OF THE BODY IN HEALTH AND DISEASE. 

race. Experimentally tuberculosis may be pro- 
duced in all susceptible animals by the injection 
of tuber clebacilli or their spores. Some animals 
are immune from this disease; all experiments 
having failed to produce the disease. Undoubtedly 
in the human subject the chief avenue through 
which the bacillus tuberculosis enters is by way 
of the air passages. It may be produced through 
wounds through the skin, or it may be introduced 
by food, as the eating of tuberculous food. When 
they are inhaled into the lungs if they find a favor- 
able site for development they grow and multiply. 
Their preference in the lungs is the upper part 
evidently the most unventilated part of the lung. 

TUBERCULIN. 

Tuberculin is the product of old cultures of the 
tuberclebacillus strained. It was once thought 
that it would prove a cure for tuberculosis, and 
was used extensively in hospitals, but proved a 
failure. It is however an interesting substance. 
When injected into a man or animals suffering 
from tuberculosis it produces a marked reaction. 
It elevates the temperature in a very short time, 
and produces a degree of inflammation around 
tuberculous sites, but in healthy animals or healthy 
persons it produces no effect as far as can be deter- 
mined. 

BACILLUS INFLUENZA. 

It is a very small, slender non-spore forming 
organism. It is nonmotile. It can be stained 
with a number of stains. It does not develop well 
except at temperatures near that of the human 



BACTERIOLOGY. 47 

body. It is the organism that produces influenza; 
sometimes called catarrhal fever; sometimes called 
lagrippe. 

In the influenza patient it is found in the sputa 
and in the nasal secretions, and also in the tissues 
of the body in persons dead of the disease. 

BACILLUS OF DIPHTHERIA. 

This organism varies somewhat in appearances 
owing to its method of staining. It is a very small 
rod with rounded ends. It can be obtained from 
the false membrane that forms on the throat of 
those suffering from the disease. When injected 
into the lower animals the disease can be produced 
in a number of the lower animals at the piint of 
injection. It grows on a number of media. It 
is easily killed by a number of antiseptic substances. 
Its most favorable temperature for cultivation is 
something near that of the human body. 

BACILLUS OF TYPHOID FEVER. 

This bacillus is regarded as the cause of typhoid 
fever. It is about three times as long as thick, 
with rounded ends. It is very actively motile. 
There is a method of staining of it that shows feet 
like processes. It grows best at a temperature 
near that of the human body. 

In patients suffering from typhoid fever the or- 
ganism has been found during life in the blood, 
urine, and feces, and in those dead of the disease 
the spleen, kidney, liver, intestinal lymphatic 
glands, and intestines. It is cultivated largely 
from the discharges. Typhoid fever has been 



48 CARE OK THE BODY IN HEALTH AND DISEASE. 

produced in some of the lower animals by the 
injection of this organism. 

A very peculiar effect is produced on this organ- 
sm when brought in contact with the serum of 
the blood of a patient suffering from typhoid fever. 
The organism is actively motile, and if the serum 
of a drop of blood be taken from a typhoid patient 
and added to a drop of fluid containing the bacilli, 
the bacilli will be seen to gradually cease to move. 
This is called the widal reaction. 

THE SPIRILLUM OF ASIATIC CHOLERA. 

This organism is an exceedingly small organism 
and is curved like a comma, and sometimes called 
the comma-bacillus. It is actively motile. It is 
found in the discharges of cholera patients, and is 
undoubtedly the organism that produces that 
disease. It too, is most easily cultivated at a 
temperature approaching that of the human body. 
It multiplies with exceeding rapidity, and is found 
in great abundance in the diarrheal discharges of 
cholera. It is very sensative to high temperatures 
and it is killed before the water reaches the boiling 
point. The disease has been produced on lower 
animals by various methods. 

BACILLUS ANTHRACIS. 

This organism is one of considerable interest; 
being larger than the most of organisms. Its life 
history has been very definitely ascertained. It 
is the organism that produces murrain in cattle. 
It is a rod shaped organism with square cut ends. 
It is most easily cultivated at a temperature of 
the human body. It multiplies by the formation 



BACTERIOLOGY. 49 

of spores, and can be produced in various other 
animals artificially. 

BACILLUS OF TETANUS OR LOCKJAW. 

This is a slender rod with rounded ends. It is 
motile; but not actively so. At the temperature 
of the body it rapidly forms spores. It stains by a 
number of methods, and the disease can be trans- 
ferred from one animal to another by injection. 

CLINICAL HISTORY OF SOME OF THE MOST 
COMMON DISEASES. 

As disease is something that concerns everybody 
it appears well that the people should be enlightened 
as much as possible about it. I will here give a 
short description of some of the most common 
diseases to which the human body is liable. 

PULMONARY TUBERCULOSIS. 

In this article I will describe the acute and sub- 
acute forms of the disease, and then the chronic 
form. The disease is often very insidious in its 
development. In some cases the lung symptoms 
are preceded weeks or months by a general decline 
in health, noted by the loss of weight, impaired 
strength, and a pallid aspect. These premonitions 
are not seen in every case, and where they exist 
are not always sufficiently marked to excite the 
attention of the patient. In a considerable number 
of cases the pulmonary symptoms are not accom- 
panied by any ailments that lead the patient to 
suspect the existence of any disease. In a large 
number of cases when the patient comes under the 
care of the physician the disease has existed for a 



50 CARE OF THE BODY IN HEALTH AND DISEASE. 

considerable while. Of the pulmonary symptoms 
at first that excite attention one of the chief is 
cough. It is often very slight at first, dry and 
hacking, and sometimes excites no attention. 
Expectoration is wanting at first in many cases, 
but as the disease advances the patient expector- 
ates froth with small hard lumps in it. 

Spitting of blood is a common sympton in the 
early stages. The amount is small in a large 
majority of cases. Pain in the chest is very com- 
monly complained of, and the patient usually 
complains of a sore chest. The pain is often sharp 
and lancinating or stitch like, and is generally 
referred to the summit of the chest. 

The disease nearly always begins on one side, 
at the top of the lung ; and after it advances consid- 
erably the other lung becomes involved. The 
patient is usually pale, with flushes on the cheeks 
at times. During the first stage of the disease 
the pulse are usually accelerated. This is generally 
in proportion to the activity of the disease. Where 
the pulse are very frequent in the early stages of 
the disease, it indicates a rapid course of the disease. 
In the acute form of the disease the temperature 
is more or less always elevated in the first stages 
of the disease. The increase in temperature is 
more or less an index to the progress of the disease. 
The temperature is usually higher of an evening 
than morning. The pulse also are usually acceler- 
ated more of an evening than of morning. The 
patient usually complains of chilly sensations, 
and as the disease advances sometimes has chills. 

The appetite is variable; generally is more or 
less weakened. The ability to digest food is gener- 



BACTERIOLOGY. 5 1 

ally impaired, and in some cases there is an entire 
loss of appetite. This is a very unfavorable feature 
of the disease. 

In some cases there is a diarrhea in the first stage 
of the disease. Impaired nutrition is frequently 
one of the earliest symptoms. As a rule reduction 
in weight is continuous as long as the disease is 
active ; and when patients gain in weight the disease 
may be considered as non-progressive. The intel- 
lectual faculties are usually unimpaired. Patients 
are generally very cheerful. As the disease advances 
all the symptoms mentioned become more severe. 

Many cases are affected by co-existing affections. 
The occurrence of tuberculous disease in intestines 
or of the larynx or of the kidneys, and a chronic 
peritonitis sometimes complicates the case. The 
duration of the disease varies greatly. The acute 
and sub-acute varieties of which I am now treating 
usually live from six months to two years; but 
sometimes the disease runs a rapid course and 
proves fatal in two or three months or even less 
time. Sometimes even in these acute cases the 
patient will improve for a short while, put on 
weight and gain a good appetite; but this usually 
does not last long. Near the close of the disease 
the patient becomes amaciated to an extreme 
degree. The old authors attributed this disease 
to a hereditary predisposition; but it has been 
found that the cause of the disease is the bacillus 
tuberculosis; although the constitution has to be 
in a suitable condition before the disease will 
develop. As constitutions are generally inherited, 
those of a weak constitution are the ones that are 
prone to suffer from the disease. 



52 CARE OF THE BODY IN HEALTH AND DISEASE. 

The period of life in which the disease is most 
often found is from 18 to 35 years, 'though it is 
frequently seen even in the aged. 

While many hold that many cases of this disease 
can be cured I am doubtful if any cases of acute 
tuberculosis ever get well. By proper dieting and 
good hygiene, life may be prolonged, but to affect 
a permanent cure I am very doubtful. 



HYGIENE AND NURSING. 53 



CHAPTER VI. 

HYGIENE AND NURSING. 

The patient should have his digestion improved 
and be nourished with good nourishing diet; take 
exercise as much as he is able when the weather 
is good, and in the more favorable cases he may 
be sent to a dry high climate. The patient should 
sleep in a well ventilated room, but in cold damp 
weather the room should be kept warm and dry. 
Just inhaling the cold air lowers the vitality of the 
lungs, and often gives the patient cold, and is to a 
disadvantage. Over-exercise has to be avoided, 
patients sometimes think that the benefits from 
exercise is proportionate to the amount, they 
greatly overdo themselves. 

Horseback exercise is to be preferred when foot 
exercise is not well borne. The body should be 
protected against the changes in atmosphere by 
yarn underclothing, and the clothing should be 
proportioned to the temperature. Persons endowed 
with resolution and energy; other things being 
equal; are more likely to struggle successfully with 
the disease than those who are deficient in these 
qualities. 

CHANGE OF CUMATE. 

The patient having been made aware of the nature 
of his disease, the next question is — shall he change 
climates. In certain cases change of climate in 



54 CARE OF THE BODY IN HEALTH AND DISEASE. 

the acute form of the disease, will no doubt prolong 
life. In the earliest stages of the disease will be 
the time to make the change. After the disease 
has advanced and the patient is bedridden he would 
be better off at home. 

The climates most suited for tuberculous patients 
are those that have a large amount of dry weather. 
For winter time, warm climate. A high climate 
that has a heap of dry weather and little or no fogs, 
and not subject to much change, is the most suit- 
able for patients suffering from pulmonary tuber- 
culosis. Arizona or New Mexico are about the 
best in the United States, 

CHRONIC PULMONARY TUBERCULOSIS. 

This form of tuberculosis develops very slowly, 
and nature makes a considerable effort to cure. 
In the early stages of the disease while the patient 
has a cough, and sometimes hemorrhage. The 
patient has no fever, and little or no acceleration 
of pulse. Like the acute form of the disease, it 
begins in the upper part of the lungs, and the 
tissues often throw a wall around the tuberculous 
deposits. The deposits sometimes break down 
and are expectorated, leaving secreting cavities. 
This form of the disease may exist almost an in- 
definite time without any notable amaciation, 
and even the patient may live many years and die 
from some other disease. Of course this is the 
most favorable termination. The hygienic treat- 
ment is of very great importance in this disease. 
The digestion should be kept in good condition, 
and the body nourished to the fullest extent, and 
the patient take a good amount of exercise by 



HYGIENE AND NURSING. 55 

walking and riding on horseback, and in the early 
stages it is often highly useful to go to a high, dry 
and warm climate. 

pneumonia. 

In the vast majority of cases this disease is ushered 
in by a chill. Quick strong pulse with a high tem- 
perature; flushed face, and extremely rapid breath- 
ing a dull pain in the chest, with a cough, and very 
generally a rusty colored expectoration; the color 
being owing to the intimate mixture of blood with 
the sputa. This rusty sputa is characteristics of 
pneumonia. Some cases run their course without 
it, but typical cases not often. The expectoration 
is sometimes like prune juice. The patient breathes 
from forty to eighty times a minute in many cases. 
Headache is very common. Delirium is not very 
common, but when it does occur it is of ill omen. 
The urine is high colored and that of fever. 

The part of the lungs that are involved becomes 
solidified and excludes the air from the part of the 
lung involved. One lobe only may be affected, 
or one on either side may be affected, constituting 
a double pneumonia; or all of one side may be 
affected, and the severity of the disease is more 
or less proportionate to the amount of lung involved 
aside from the disease in the aged in whom all 
forms of it are severe, and very generally fatal. 

This disease pursues a very rapid course and 
terminates in from six to ten days in a crisis, should 
the patient withstand it. It always has more or 
less a high temperature, ranging from 103 to 105 
fahrenheit. When it terminates it is very generally 
abruptly. 



56 CARE OF THE BODY IN HEAI/fH AND DISEASE. 

Respecting the nursing in this disease, the pa- 
tient should be placed in a good airy room and not 
allowed to get out of bed. and in severe cases, not 
even to raise his head. 

An exceedingly light diet is suitable during the 
height of the disease. Animal broths, milk and 
buttermilk, with cooling drinks, such as lemonade, 
is about all the patient needs in the way of eat- 
ing and drinking until he becomes convalescent 
In convalescence the diet may be more liberal, 
such as soft eggs, tender chicken, and other light 
diets may be added. During fever the patient 
should be allowed plenty of water. 

TYPHOID-FEVER. 

This fever approaches more slowly than any 
other belonging to the types of fever. It is ushered 
in by a loss of appetite, misery in the limbs, general 
indisposition and a gradual rise of temperature. 
As a very general rule rising a degree higher of an 
evening than that of a morning ; going a little higher 
every day until the second or third week. The 
patient generally complains of soreness in his limbs, 
and very easily fatigued, and headache. His sleep 
is unsound, and his nervous energies are weakened. 
He of ten has slight chilly sensations which alternate 
with flushes of heat. His appetite is entirely gone, 
his tongue is coated, and in all but the very mildest 
cases a diarrhea sets in the first, second or third 
week. The tongue is usually dry; sometimes 
parched, and is often glazed; sometimes it has deep 
fissures in it. The gums and teeth are frequently 
colored with a dark crust; the mind is dull ana 
wondering. As the disease advances in severe 



HYGIENE AND NURSING. 57 

cases, the patient often becomes delirious. The 
pulse is accelerated as a rule more or less, in propor- 
tion to the height of the fever. The urine of the 
fever is of high color. Diarrhea is always a ^prom- 
inent symptom in the latter part of severe cases. 
It is never absent except in very mild cases. Gen- 
erally it is a very early symptom. Its cause is 
undoubtedly due to the ulcers on the bowels, and 
is a conservative process set up by nature to get 
rid of the poisons engendered by the micro-organisms 
feeding on the bowels. The bacilli of typhoid can 
be obtained from this diarrheal discharge. The 
rub with the patient is usually in the fourth week. 
He is now weakened greatly for want of nourish- 
ment, and in no other disease will one get so low 
as in typhoid, and yet recover. The decline of 
the fever in favorable cases usually begins in the 
fourth week, and declines rather slowly. When 
the fever ends great care should be exercised in 
the selection of a suitable diet. The patient is 
not yet out of danger. Even weeks after the end 
of the fever patients have died from an error in 
diet. When the patient is known to suffer from 
typhoid it is very desirable to have an intelligent 
nurse to nurse him. He should be placed in a well 
ventilated room and kept as quiet as possible, and 
not allowed to weary, and visitors as a rule should 
be excluded from the room. He should have 
plenty of good cooling drinks, such as lemonade 
and ice water. The diet should consist of butter- 
milk partially sour, and chicken broth,, to the end 
of the disease. I have often found sweet milk to 
disagree and pass undigested. 

In convalescence it has been a question how 



58 CARE OF THE BODY IN HEALTH AND DISEASE. 

long the patient should be kept on a fluid diet. 
I think at least ten days, and when solid food is 
given, very small quantities should be given, and 
the amount gradually increased. 

INTERMITENT FEVER. 

The Paroxysm is ushered in by a chill, the face 
becomes pale, the lips bluish, the teeth chatter, 
the skin is cold, and there is a feeling of uneasiness 
and fatigue. After a period variating from a half 
to one hour, this cold stage passes off. Now, a 
fever begins to rise with restlessness, thirst, a rapid 
pulse, pains in the muscles, and scanty secretions 
of urine. This stage continues for hours, then a 
sweat usually breaks out on the body, the pulse 
becomes soft and less frequent, the secretions are 
re-established and this sweating stage terminates 
the paroxysm. The patient is now, for the time 
being, well, but in from twenty-four to 70 hours 
the paroxysm repeats itself. 

In the former case, the fever is called a Quoti- 
dian, in the latter, Quartan. The name Tertian 
Type is applied to this disease, when the chills 
occur at intervals of forty-eight hours, but in the 
occurrence of the chill, there are some irregular- 
ities in some cases. The varied types of the fever 
have a marked difference in the character and dur- 
ation of their several stages. Thus, a sweating 
stage may precede the cold stage, when in some 
cases it may be the only one that shows itself, and 
in other cases, the rigor may be wanted. Some- 
times there are no distinct stages, the patient is 
then said to have dumb ague; this is manifested by 
feelings of great depression. These^ cases are often 



HYGIENE AND NURSING. 59 

accompanied by headache nausea and vomiting 
and painful sensations in various parts of the body. 
In cases of this kind, it is often difficult to clear 
the diagnosis from other diseases. This can only 
be done by getting at the history of the case, and 
periodical nature of the disease. This disease is 
produced by a micro-organism called the Plasmo- 
dium Malaria, that assumes an active stage period- 
ically. There is no doubt that there is several 
species of the organism. The care of the patient 
consists in his resting in bed during the existence 
of the paroxysm. The bowels should be free, 
with some active purgative and large doses of sul- 
phate of quinine administered two or three times 
per day till the paroxysm cease to recur. From 
ten to twenty grains of quinine may % be given to 
an adult two or three times per day. This, with 
the proper attention to the appetite comprises 
the treatment. 

REMITTENT FEVER. 

Remittent fever has no well-defined symptoms. 
The disease generally begins with a chill succeeded 
by fever, and after a varying period the fever de- 
clines but does not intermit, and again rises. The 
patient has pain and throbbing in the head, and is 
generally very restless, his limbs ache, and his 
tongue is coated; he is thirsty, and he often vomits. 
After the fever continues for an indefinite time it 
again remits. He often sweats at intervals. He 
sometimes becomes composed and cheerful, his 
head ceases to ache, but again this lull does not 
last but a few hours. Fever rises again, pulse is 
full, frequent and hard. With the sweating stage 



60 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

the fever declines, usually several degrees, soon to 
rise again, and there is a fall or remission again 
with another quick rise which sometimes attain a 
very high point; even to 105 and 107 degrees. The 
greatest height is usually reached from the third 
to the fifth day. After this the remissions are 
usually less distinct and can only be recognized 
by the use of the thermometer. When the fever 
ceases temperature usually falls below the normal. 
The duration of the fever is generally from ten to 
twelve days. 

The urine in remittent fever is high colored and 
has a large amount of solids. The disease is very 
readily recognized by the experienced physician 
Its characteristic symptoms are more closely allied 
with those of intermittent fever than perhaps any 
other disease. 

In intermittent fever each paroxysm begins with 
a chill, which is not the case in remittent fever after 
the first paroxysm there is not often any more, 
and this one is not so violent as in intermittent. 

In regard to the nursing, the patient should be 
placed in a good airy room and allowed cold drinks 
and a light diet, such as sour buttermilk, animal 
broth, etc. and that comprises the diet. 

YELLOW EEVER. 

This fever takes its name from the color the skin 
assumes in the progress of the disease. It is a dis- 
ease peculiar to hot climates. It is undoubtedly 
due to a micro-organism, and is no doubt sometimes 
conveyed by the mosquito. It is a disease of very 
short duration; many die before the fifth day of 
the disease, It has but one paroxysm which is 



HYGIENE AND NURSING. 6l 

usually divided into three stages. The first stage 
is pre-eminently the febrile stage. Its duration 
is from 36 to 48 hours. The onset is usually very 
sudden, and begins with a chill; and in desperate 
cases death takes place before reaction occurs. 
More generally the chillis followed by febrile excite- 
ment. The patient has a high fever, the pulse is 
quick, the face is flushed, the eyes are brilliantly 
injected. The patient is usually conscious, rest- 
less and anxious, and complains much of pains in 
his head and limbs. His muscles of his extremities 
are sore, his respiration is hurried, his stomach is 
irritable and painful on pressure, and he is usually 
very thirsty. His bowels are constipated, his 
tongue is coated 'though not dry. Sometimes 
the tongue remains natural throughout the disease. 
The fever rises toward evening and falls of a morn- 
ing, 'though it does not distinctly remit until from 
thirty-six to forty-eight hours when remission occurs. 
The disease now appears in its second stage; 
the fever subsides ; the pulse improves in character ; 
the headache is relieved; the temperature declines 
to near the normal. Now the eyes turn of a deep 
yellow and the skin is more or less jaundiced over 
the body. The patient becomes cheerful, and 
often wishes to get up. In some cases convales- 
cence begins and he slowly gets well; but more 
generally the disease is not at its end. The decep- 
tive improvement hardly ever lasts more than a 
day. The patient grows again very uncomfortable 
and anxious. Symptoms of the first stage reap- 
pear with increased intensity. The pulse sink 
and becomes slow. The skin is cool, dry, and in 
some cases of a bronze hue. 



62 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

Livid spots sometimes make their appearance 
at this stage of the disease. The patient's stomach 
is very irritable and he frequently vomits. Some- 
times a black vomit, which is due to a hemorrhage 
of the stomach. Delirium now frequently sets in 
and the patient sinks frequently. In some cases 
the mind remains clear almost to the last, and the 
strength even be but little impaired. Should re- 
covery take place it is very slowly. The disease 
does not appear in every epidemic with the same 
severity. Some epidemics run a mild course; 
whereas in other epidemics about half the patients die. 

The more rapidly the stages succeed each other 
the more dangerous is the disease. The occurrence 
of black vomit, suppression of urine, delirium, and 
of oppressed breathing, or of convulsions and fiery 
glistening eyes are very unfavorable symptoms. 
The maximum elevation of temperature in yellow 
fever is attained upon the first, second or third 
days, and ranges from about 102 to no. degrees 

A rapid rise of temperature has an ill significance. 
Of late years a number of experiments have been 
made with the mosquito, and beyond a doubt it 
is proven that they transfer the disease; at least 
in some instances from one to another. One noted 
physician in experimenting on himself allowed a 
mosquito to bite him, which had bitten a patient 
suffering from the disease, and took yellow fever 
himself and died with it. 

Respecting the diet in this disease, the very 
lightest diet is most suitable. Fluid diet is to be 
preferred, such as milk and animal broths, and the 
patient kept perfectly quiet and free from annoy- 
ances in a well ventilated room. 



HYGIENE AND NURSING. 63 

CEREBRO SPINAL MENINGITIS. 

This disease is often called cerebro spinal fever 
and epidemic meningitis. The disease appears 
sometimes in isolated cases, and sometimes in an 
epidemic form. It does not always present the 
same symptoms. The onset in the vast majority 
of cases is rather abruptly. The approach is ush- 
ered in by chilly sensations, headache, and tender- 
ness of the muscles of the back of the neck. Some 
times the patient vomits. The severe headache 
is often associated with vertigo and sometimes 
delirium and stupor. 

A symptom that is more or less always present 
is stiffness of the neck. In very severe cases this 
may extend to the lower extremities so the patient 
may be lifted to his feet by his head. The head 
is usually thrown back and rigidly fixed. The 
face of the patient is that of suffering and he is 
generally very restless. He trembles and talks 
incoherently; the pupils of his eyes are generally 
dilated. There is usually dimness of vision, and 
sometimes double vision. The skin is dry and very 
sensitive. The surface of the skin frequently looks 
spotted with a reddish eruption; it sometimes 
becomes of a brownish character. 

The pulse at first may be either natural or slow; 
usually it becomes frequent, and sometimes irreg- 
ular. The pulse usually remain accelerated through- 
out the disease, 'though it shows considerableo 
variations as to acceleration during a few hours. 
The tongue maybe moist, dry or brown. The breath- 
ing is often shallow and somewhat accelerated. The 
bowels are often at the outset constipated, but 



64 CARE OF THE BODY IN HEAI/fH AND DISEASE. 

as the disease advances they often become lax. 
The stomach is somewhat irritable; the patient is 
thirsty and often has convulsive movements of 
the extremities. With these symptoms the disease 
goes on to its close, presenting sometimes remissions 
that would lead one to believe that the patient was 
convalescent. 

In the fortunate cases the symptoms gradually 
lose their violence and the patient very much ama- 
ciated enters upon convalescence. The temperature 
varies greatly in different cases. Occasionally 
at the outset there is no fever; but sooner or later 
the temperature becomes elevated; but in fatal 
cases it often does not run very high; but in some 
cases runs as high as from 108 to no degrees fahrin- 
heit. The duration of the disease is very various. 
The patients often die in three or four days and 
sometimes in less than 24 hours. Sometimes they 
may live weeks and then die from the disease. 

As to the cause of the disease it belongs to the 
infectious diseases, and recently a germ has been 
found. Children are most frequently victims of 
the disease 'though grown people have it also. 
It is more common in winter and spring than it is 
in summer. 

This disease is one of the most fatal of children's 
diseases. A fair average mortality would be from 
60 to 80 per cent. As regards the nursing it does 
not differ from other severe fevers. 

ACUTE RHEUMATISM. 

Acute rheumatism is now regarded by most 
authorities as produced by a micro-organism. It 
is a disease of the joints; the larger ones being 



HYGIENE AND NURSING. 65 

chiefly affected. The joints swell and become red 
and tender. They are the seat of considerable pain. 
It is considerbly aggravated by movement. The 
inflammation may remain confined to the joints 
first affected until the disease terminates, but very 
much more common it shifts from one joint to 
another, involving most of the large joints in suc- 
cession. The disease is ushered in and accompanied 
by a high fever and a full bounding pulse. The 
perspiration is usually sour. The tongue is coated 
and the countenance is one of suffering. The 
fever is often in proportion to the number of joints 
involved. The temperature ranges from 102 to 
104, and generally remains steady to the end of 
the disease, with slight morning remissions. As 
the disease disappears the temperature gradually 
subsides. When the disease is well developed it 
is not difficult to recognize it. Pains in the joints, 
the swelling and tenderness, the shifting character 
from one joint to another, the fever, the sour pers- 
piration, form a group of symptoms that is highly 
characteristic. 

As to the nursing, the] patient should be kept 
perfectly, quiet, be fed a light diet, such as milk 
and animal broth. 

APPENDICITIS. 

Appendicitis is an inflammation of the appendix. 
The appendix is a little blind ended organ attached 
to the head of the large bowel. It is about the 
size of a goose quill as a rule, and three or four 
inches long. It lies on the right side, and unless 
anchored by adhesions it is free to move about. 
The disease to which it is subject is appendicitis. 



66 CARE OF THE BODY IN HEALTH AND DISEASE. 

The lumen of the tube admits of small particles of 
waste products in the bowels to get out in it, and 
sometimes seeds find their way into it and have 
been thought to have something to do with causing 
the disease. The symptoms of appendicitis are 
pain and tenderness in the region of the appendix. 
A hard roll or mass can often be felt when the ab- 
dominal muscles are relaxed. There is more or 
less always some elevation of temperature. The 
fever varies in different cases. In severe cases 
the temperature is not always very high. The 
pulse are usually accelerated, and the bowels con- 
stipated. 

The patient's appetite is poor and he is generally 
thirsty. Now there are several ways in which 
appendicitis may terminate. It may terminate 
first by the inflammation subsiding and the pa- 
tient's recovery; or it may become gangrenous 
and slough off, and the contents of the bowels 
escape into the abdominal cavity and set up per- 
itonitis with a fatal result; or it may terminate in 
pus formation and by adhesions be walled off from 
the cavity of the abdomen. This pus formation 
may rupture in the abdominal cavity and set up 
peritonitis. The majority of the cases terminate 
in resolution under proper management; that is, 
the inflammation subsides without terminating in 
gangrene or pus formation. There is hardly any 
disease known that has been more discussed of 
late years than that of appendicitis. Prior to 16 
or 1 8 years ago it was treated medically altogether, 
but now it is considered partly a medical and partly 
a surgical disease; although there are a large num- 
ber of surgeons regard it as a surgical disease, while 



HYGIENE AND NURSING. 67 

there is another class of surgeons who are more 
conservative in their views regard it as both a med- 
ical and surgical disease. There has been volumes 
and volumes written upon it for the last few years, 
and thousands have had their appendix removed, 
and still the question cannot be settled as to whether 
all cases should be operated upon or not. A great 
many surgeons advocate removing of it at once; 
as soon as the diagnosis is made, while others 
equally as eminent only operate in selected cases. 
Both claim the best results and the question is still 
unsettled. 

Those who once have the disease seem to be 
very liable to subsequent attacks. When operated 
on very early the mortality is rather low; but often 
the surgeon does not see the case until the disease 
is considerably advanced, and in the mild cases 
many will not subject themselves to an operation. 
Under proper treatment without the use of the 
knife it is likely that 80 or 90 per cent, at least will 
recover, or perhaps more. It is often a little diffi- 
cult to make a clear diagnosis, and there can be 
no doubt that many are operated on that have no 
appendicitis. Upon the whole I am with the con- 
servative view myself. In mild cases in whom 
there is no dangerous symptoms I would treat the 
case medically; but should the case progress for 
the worse after a fair trial of medical procedures, 
I would advise an operation. It is just a little 
hard for to tell what cases are most suitable for 
operation. Of course in cases of pus formation 
the patient should be operated upon, but it is not 
always possible to tell when pus is forming, or to 
tell when the appendix has become gangrenous. 



68 CARE OF THE BODY IN HEALTH AND DISEASE. 

If Jthese points could be made clear in every case 
I think there would not be so much difference of 
opinion as to when an operation is indicated. 

DIPHTHERIA. 

Diphtheria begins with a sore throat, with red- 
ness and swelling of the palate and tonsils. There 
is a slight stiffness of the neck as a rule, and the 
little glands in the back of the neck and the glands 
under the jaws are often enlarged and tender. 
Within the course of a day or so there is a mem- 
brane form on the tonsils and the palate. It is 
of a white or grayish hue and generally tough. It 
may extend into the windpipe or into the nostrils. 
The membrane once formed gradually darkens and 
assumes rather a dirty appearance. After the 
first week from the beginning the membrane is 
not apt to reform; but in the early stages if it is 
removed in any way it reforms for the most part 
rapidly. The constitutional symptoms vary greatly. 
The pulse are usually frequent, the skin hot, and 
there is much pain in the head. In fact the symp- 
toms are those of fever. The temperature usually 
ranges from 102 to 104, 'though this varies consid- 
erably in some of the worst cases, and the temper- 
ature is low; nearly normal. The patient is greatly 
prostrated from the beginning of the disease. In 
some cases a typhoid condition develops. This 
often happens when the membrane decomposes 
and gives rise to offensive odors, and is often called 
septic forms of the disease. In such cases the 
temperature is always low. 

In diphtheria the danger arises partly from the 
depressing effect of the poison which is caused by 



HYGIENE AND NURSING. 69 

the poison gaining access to the circulation. The 
poison is evidently produced by the germs in their 
multiplication and development, and it is said 
that exceedingly small amounts of it will prove 
fatal when injected into lower animals. Another 
danger is that the disease may extend into the 
windpipe and suffocate the patient, and in other 
instances heart failure is the immediate cause of 
death. Sometimes the disease appears in a very 
severe form, and is accompanied by a high mortal- 
ity, and in other epidemics it appears in a mild 
form. 

In regard to the nursing, as soon as the disease 
is made out the patient should be kept in an isolated 
room; the eating utensils should be sterilized with 
boiling water; the patient should be kept perfectly 
quiet, and in bad cases should not be allowed to 
get out of bed. Persons convalescing from this 
disease and thought to be out of danger, by a little 
exertion has caused heart failure and immediate 
death. Most authorities recommend a liberal diet; 
that is, rather a rich diet, but in severe cases it is 
very doubtful that a rich diet proves of any use, 
as the system is often unable to digest it. Where 
the appetite is fair the patient may be allowed a 
liberal diet of good nourishing food, but when the 
appetite is wanting, milk and broth is probably 
superior to any other. 

SCARLET-FEVER. 

For the most part scarlet fever is met with among 
children, 'though sometimes adults have the dis- 
ease. It is characterized by great heat of skin, 
frequent pulse, sore throat, and a scarlet eruption. 



70 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

The skin is very hot and generally dry, and the 
pulse so frequent that by these signs alone, in the 
midst of an epidemic the physician may be able 
to make a diagnosis. The temperature does not 
fall with the appearance of the eruption but con- 
tinues high until the eruption is fairly developed, 
and it slowly declines as the eruption does. The 
rash usually appears on the second day of the dis- 
ease. It comes out almost simultaneously all 
over the body. At first the surface exhibits almost 
a uniform red blush, which will on pressure to some 
extent disappear. In other words, the pressure 
leaves a white stain on the skin which quickly 
again reddens on removal of the pressure. The 
eruption declines on the fourth or fifth day. By 
the seventh or the eighth the cuticle begins to 
come away in scales. Occasionally the rash, when 
at its height, recedes and then appears again. In 
malignant cases it makes its appearance late, and 
is usually dark and livid in appearance. 

In some instances it is wanting altogether. The 
sore throat of scarlet fever is very characteristic 
of the scarlet rash. It develops early in the dis- 
ease; before the eruption. At the beginning sore 
throat consists of redness of the tonsils and the 
palate. The tonsils are generally swollen. The 
patient complains of pain in his throat. There 
is also some stiffness of the muscles of the neck. 
The glands of the jaw become much swollen, and 
sometimes pressing on the vessels of the neck will 
produce a stupor. This is considered a grave 
symptom. There is a false membrane develops 
on the tonsils, which in many cases resembles 
diphtheria. The tongue has a peculiar appearance. 



HYGIENE AND NURSING. 71 

At first it is thickly coated; the borders being red; 
pretty soon the coat is cast off and the whole organ 
looks red like a strawberry. In bad cases the 
tongue sometimes becomes very dry and assumes 
a brownish hue. In children the disease is some- 
times ushered in by convulsions. There is a great 
deal of difference in different epidemics of the 
disease. Some are very severe, accompanied with 
considerable mortality, while in other epidemics 
the disease is quite mild and all get well. vScarlet 
fever being a contagious disease, the cases should 
be separated from other children, and when the 
patient gets well, as the scales are left on the bed 
clothing, the bed clothing should be subjected to 
thorough scalding. Nursing is the chief remedy 
in this disease. The patient should be confined 
to bed in a good airy room and fed on a light fluid 
diet. 

MEASLES. 

Measles begin the attack by fever, frequent 
sneezing, considerable flow from the nose, the pa- 
tient coughs, and at first the disease resembles 
acute catarrh or cold. To these symptoms in many 
instances a diarrhea is added. On about the fourth 
day after the beginning of these morbid signs a 
rash appears on the face and neck first, then it 
extends in the coarse of a day or two to the whole 
body. During the first day of the disease the 
temperature as a rule goes up to 102 to 104 degrees. 
On the second or third day; usually the second, 
the temperature goes down near the normal. About 
the fourth day it rises again. The occurrence of 
the rash does not remove the febrile symptoms. 



72 CARE OF THE BODY IN HEALTH AND DISEASE. 

While it is spreading to the lower extremities the 
constitutional disturbance lasts and the tempera- 
ture remains high. As soon as the rash has reached 
its height the temperature rapidly falls. By the 
ninth day of the disease, as a rule, the rash and the 
fever are absent. As a rule the cuticle comes away 
in fine scales with a severe itching. The patient 
now convalescent, shows his illness, and is rather 
pale and amaciated. He still coughs, and his eyes 
are slightly inflamed. 

The peculiarities of the eruption is that it consists 
of slightly raised red spots which coalesce and form 
blotches of an irregular crescentic shape. The 
eruption disappears from the face first; in other 
words it disappears in the order of its appearance. 

Measles is a contagious disease and the cases 
should be isolated and the patient kept in the house 
and at rest; the diet should be light, and the bed- 
ding subjected to scalding after the recovery of 
the patient. 

GERMAN MEASLES OR RUBELLA. 

German measles is sometimes called Rubella, 
is a different disease to ordinary measles, and one 
does not protect against the other. The disease 
begins by fever, chill, accompanied by running at 
the nose, cough and sore throat. The fever before 
the eruption lasts two or three days. The temper- 
ature rarely exceeds 102 degrees; the rash may 
appear all over the body at once, or in course of a 
day spread all over the body. It often appears 
on the face first and is usualy most distinct on the 
face and neck; being more scattered on the rest 
of the body. At first it resembles ordinary meas- 



HYGIENE AND NURSING. 73 

les very much, but the spots are round or oval and 
smaller and paler than they are in measles. They 
soon run together in irregular patches unlike the 
crescentic eruption of measles. 

The patches vary very much in size, and unlike 
the rash of scarlet fever are surrounded by healthy 
skin. The small spots appear around the large 
ones. They have the deepest color in the center, 
but not bright colored as they are in measles nor 
of the dark red of scarlet fever. The eruption 
usually lasts four or five days, but in severe cases 
it lasts eight or ten days. It gradually fades. It 
sometimes fades on the face before it has fairly 
come out on the legs. The scales are very small; 
being much smaller than those of scarlet fever. 
The rash is often attended with considerable itch- 
ing. The sore throat and catarrh may be very 
severe, and is usually attended with hoarseness 
and sometimes inability to swallow. 

The disease is sometimes very difficult to distin- 
guish from measles, except when it is epidemic or 
affects those who have already had ordinary meas- 
les. The more certain onset with a milder fever, 
and the peculiarities of the eruption already spoken 
of are the only guides to distinguish between them. 

The disease is a contagious one. The patients 
should remain in the house and be isolated from 
others. As to the hygienic management, it should 
be the same as in ordinary measles. 

It might be stated here that all these eruptive 
fevers like measles, German Measles and Scarlet 
Fever, require care in regard to getting the body 
wet. The patient should not be exposed to a very 
damp atmosphere even, until he is fairly well. 



74 CARE OF THE BODY IN HEALTH AND DISEASE. 

Consequently patients should be kept in doors 
until they get well. 

SMALL-POX OR VARIOLA. 

Small-pox is one of the most contagious of dis- 
eases. The symptoms of the first stage or the stage 
of invasion are chills, fever and pains in the back. 
The fever is sometimes very high, but in mild cases 
it is usually low. Pain in the back in severe cases 
is very severe. Sometimes the pains in the limbs 
resemble rheumatism. The patient is often sick 
at his stomach — sometimes vomits, and he has a 
headache, and is generally restless. As the erup- 
tion appears these symptoms subside, which is 
usually on the third or fourth day of the disease. 
The eruption appears on the forehead and face 
first, and soon extends to the body and extremities; 
and as the eruption appears the temperature 
falls. 

At first the eruption has the appearance of pa- 
pules, but in two or three days these spots undergo 
a decided change. On the top of each papule a 
vesicle forms, which becomes larger and fills up 
with a thick milky fluid; or in other words the 
vesicle is converted into a pustule. By the fifth 
or sixth day this change is complete. The pustule 
now loses its umbilicated appearance it had while 
forming. On the eighth or ninth day matter begins 
to ooze from the edges of the pustule. Now a 
secondary fever sets in and lasts for three or four 
days, or until all the pustules are broken. This 
secondary fever is often ushered in by a chill. The 
temperature ranges from 103 to 105 degrees. By 
the time it subsides crusts form, where before there 



HYGIENE AND NURSING. 75 

have been pustules, and as these crusts dry and 
fall off the skin beneath is of a red color which only- 
very gradually fades, and here and there are no- 
ticed those scars and pits which the patient carries 
for the rest of his lifetime. When these pustules 
are fully developed they harden at their base so 
they feel like shot under the skin. 

The disease varies in different epidemics; some- 
times it is severe with considerable mortality, and 
sometimes it is mild and they all get well. The 
chief treatment is good nursing. There is no med- 
icine that has any influence over the course of the 
disease. 

The patient should be kept in a well ventilated 
room, completely; fed on a light diet, and the bed- 
ding burned or subjected to scalding and the room 
thoroughly disinfected after the patient gets well. 

ERYSIPELAS. 

Erysipelas might be regarded as an eruptive 
fever, usually beginning with a chill. The part 
affected is red, swollen and hot, and the redness 
spreads a clearly defined edge marking of its boun- 
daries; and generally if it is located on the face it 
will go over the chief part of the head. The pa- 
tient is very restless; has a high fever; the glands 
at the angle of the jaws are swollen and the throat 
is sore. In about a week the fever disappears and 
the swelling and inflammation subsides. In milder 
cases this is the termination, but sometimes the 
affection extends and frequently involves the true 
skin and forms pus. In some cases the inflamma- 
tion extends to the brain; then we have violent 
delirium and the patient sinks rapidly. Occasion- 



76 CARE OF THE BODY IN HEALTH AND DISEASE. 

ally the disease gets into the throat, and even 
reaches the bronchial tubes and places the patient 
in a perilous condition. 

The nursing requires the patient to rest in bed; 
to be fed on a light diet until the disease is over. 

SCABIES OR ITCH. 

Scabies is owing to a parasite that gets under 
the cuticle and travels around and produces the 
itching. Usually the parasite first attacks the 
fingers and thence travels to various parts of the 
body. The channels produced are generally some- 
what curved and may be traced as whitish but 
more generally black streaks. The disease is at- 
tended with an excessive itching which is worse 
at night, and with an eruption of the conical vesicles. 
The disease is often accompanied by a rash due to 
the scratching. 

It is said that balsam of peru is a positive remedy 
for it. It should be applied once a day w T herever 
the parasite is found. 

SYPHILIS. 

Syphilis is a specific disease resulting from the 
inoculation of a specific germ which multiplies in 
the system until the whole body is infected. It 
is communicated by direct contact of the blood, 
secretions, or discharges of a person suffering from 
the disease, and under certain circumstances it is 
transmitted from syphilitic parents to their off- 
spring. Syphilis is divided into acquired and 
inherited syphilis. In the acquired form of the 
disease the first stage is called the period of incu- 
bation. This period embraces the time from inoc- 



HYGIENE AND NURSING. . 77 

ulation until the chancre makes its appearance. 
The primary stage includes the appearance of the 
initial manifestations; that is, an indurated sore 
and swelling of the neighboring lymphatic glands. 

What is called the third stage of the disease is 
the stage in which the secondary symptoms make 
their appearance. These consist of eruptions on 
the tonsils, inflammation of the membranes of the 
bones, inflammation of the eyes, and the loss of 
the hair. 

The fourth stage or tertiary stage of syphilis 
embraces the more remote effects of the disease, 
such as the formation of bone tumors, deep ulcer- 
ations and various affections of the internal organs. 
All the cases do not show any tertiary manifesta- 
tions. There is no certain duration of these stages, 
and one stage merges into the other so the division 
into stages is purely artificial. The disease usually 
begins to develop in from twenty to thirty days 
after being inoculated. One attack of syphilis 
confers as a rule immunity to the patient for the 
rest of his time. Second attacks are not more 
frequent than smallpox or measles. 

The disease is acquired in the vast majority of 
instances, by sexual contact, although it may be 
acquired in other w^ays, as in kissing, or in any way 
being brought in contact with the morbid products 
of a syphilitic patient. The initial lesion is an 
indurated or hard sore that feels pretty much like 
cartilage. Some authorities of great eminence 
have stated that sometimes no hardness can be 
felt in the initial lesion. I think that is quite 
doubtful. The chancre develops in the male on 
the corona or just back of it as a rule, but it may 



78 CARE OF THE BODY IN HEALTH AND DISEASE. 

develop on any part of the head of the penis. It 
begins as a small papule, or it may begin as quite 
a simple sore. It sometimes swells in the neighbor- 
hood of the chancre, and in others there is little 
or no swelling. If the sore be kept clean there is 
only a slight discharge from it, which is a watery 
serum; but if it is allowed to go uncleanly pus may 
rapidly form, which usually aggravates the case 
and causes much swelling. Pretty soon the glands 
in the groins are found enlarged or swollen. The 
patient sometimes fevers up and suffers from loss 
of appetite, and general indisposition. The sore 
is usually painless and the swollen glands in the 
groins are generally not painful nor very sore. 

As soon as the primary sore makes its appearance 
the patient acquires an immunity from reinoeula- 
tion, so that a chancre of the hard variety, w r hich 
means syphilis, cannot be produced a second time 
on the same individual except in very rare instances. 
The primary syphilitic sore is almost invariably 
single. A chancre may form in the uretha, and 
when it does it is always near the end, and can be 
diagnosed by opening that canal. 

In women chancres are very rare on the vaginal 
wall. They sometimes are located on the mouth 
of the womb ; but in the vast majority of cases they 
are located on the external organs of generation. 
Chancres are sometimes located on the lips, and 
occasionally on the tongue, and even on the hand 
sometimes, or other parts of the body. 

Every patient who has an indurated chancre is 
already suffering from constitutional syphilis, and 
no burning with caustics, no application of any 
drugs nor excission will be of any avail whatever, 



HYGIENE AND NURSING. 79 

for nothing will prevent the patient from being 
subject to the various stages of the disease. That 
hardness may involve a considerable amount of 
tissue, or it may be very small. The severity of 
the case does not depend upon the amount involved 
in the induration. 

The initial lesion itself will finally heal as a rule, 
without treatment, 'though it is rather slow and 
requires months. 

The swelling in the groin, when amounting to 
much magnitude, is called a bubo. It may be on 
one side alone or it may affect the glands of both 
sides. 

The secondary stage is very variable in its mani- 
festations all the way from the very slightest effects 
to a severity to kill the patient. I have seen some 
cases that were typical in healthy individuals under 
proper treatment that manifested no secondary 
symptoms except a slight swelling about the glands 
of the neck, but as a rule the patient will have sores 
in his mouth, eruptions, sometimes copper coloreds 
blotches, and occasionally loss of hair; and those 
illy treated will often have large ulcers and large 
abscesses, bone-ache, loss of hair, and often im- 
pairment of general health. Weakly persons gen- 
erally bear the disease badly. Old men bear the 
disease badly, and often manifest tertiary symptoms. 
The tertiary symptoms have among them aneurism 
paralysis, iritis, deep ulcers, sometimes a loss of 
bone, and gummata or bone tumors. 

The personal habits and surroundings exert a 
powerful influence on a course of syphilis. The 
disease is seen in its worst torm among those w^ho 
suffer from insufficient food and clothing. Persons 



8o CARE OF THE BODY IN HEALTH AND DISEASE. 

given to the use of alcohol suffer wDrse. In young 
adults with sound constitutions under proper med- 
ical treatment, the grave symptoms of the disease 
are a rare thing. The state of a patient's health 
determines to a great extent the kind of an attack 
he will experience. After the symptoms of the 
disease have entirely disappeared they may be 
called into activity again by ill health or excess 
in the use of alcohol. It is a remarkable feature 
of syphilis that it often lies dormant for a long 
time and then manifests some symptoms. 

Respecting the treatment of the first stage of 
the disease, the sore should be kept absolutely 
clean by bathing three or four times a day, and 
dusted with some antiseptic like boracic acid. The 
patient should not exercise much until the swelling 
in the groins subsides. He should not drink spir- 
itous liquors, his bowels should be kept regular, 
and if his appetite be poor it should be improved 
by vegetable bitters; he should have three or four 
grains of calomel once or twice a week, and should 
take iodide of potassium in from fifteen to thirty 
grain doses, three times a day after meals, in water. 
This treatment should be kept up until the initial 
lesions disappear. Then the calomel should be 
dropped and the iodide of potassium continued in 
doses as aforesaid, for months, until all the second- 
ary symptoms disappear; and even if none are 
existing it is best to keep up the treatment for 
months, and when once it is stopped, to resume 
it at once whenever the slightest syphilitic manifes- 
tation is noticed. The patient should have a lib- 
eral diet of good rich food, and after the primary 
lesions have disappeared he may resume his occu- 



HYGIENE AND NURSING. 8 1 

pation. It is proper to state that all persons af- 
fected with syphilis should use care not to convey 
the disease to others. A syphilitic patient ought 
not to get married sooner than one year in no way, 
after being affected with syphilis. 

SOFT-CHANCRE. 

Soft chancre, as the name implies, means a soft 
sore or several soft sores; sometimes as many as 
a half dozen or more, located on the genitals of the 
male and female in about the same situations that 
the hard variety occupies. 

A typical soft chancre is somewhat eaten out 
and soft, and sometimes a little undermined. The 
surface of the sore, after it is fully developed, looks 
whitish. At the same time a bubo forms on the 
side that corresponds to the chancre or chancres, 
and if they be on both sides of the head of the penis 
there are usually two bubos in the groins. They 
are usually tender and sometimes very painful. 
They sometimes break down or pus forms in them 
and has to be evacuated. These chancres as a 
rule, need very simple management. They should 
be kept perfectly clean and dusted three times a 
day with boracic acid. They should never be 
burned as burning them with caustic often causes 
a very severe bubo. Under this simple manage- 
ment, if the patient will keep quiet and not do 
much stirring, the chancres will heal and the bubos 
disappear. As a rule soft chancres do not cause 
constitutional symptoms, but occasionally they 
<io, and when they appear they resemble the con- 
stitutional symptoms of syphilis, and should be 
treated with large doses of iodide of potassium. 



82 CARE OF THE BODY IN HEALTH AND DISEASE. 

The patient should take from twenty to thirty 
grains three times a day after meals, largely diluted 
with water, and eat a liberal diet, and the constitu- 
tional symptoms will soon make their disappearance. 
I might here say that the patient should use 
the proper cautions to avoid conveying the disease 
to others. 

GONORRHEA. 

Gonorrhea is an acute infectious and contagious 
disease produced by a micro-organism conveyed 
by sexual intercourse from one person to another. 
The period of incubation is from one to ten days. 
It begins by a discharge in the male from the urethra, 
and in the female from the vagina. 

The discharge is yellowish in color and stains 
the clothing of a greenish yellow color. In the 
uretha it begins in the front part and progresses 
backward. At first it does not give very much 
pain, but when it advances to the vecical end of 
the uretha it gives considerable pain; especially 
on emptying the bladder. 

In regard to the treatment, if the patient wants 
to get well quickly he should remain quiet and not 
work. As to the injections used they are many. 
A very efficient treatment is hot water as hot as 
the patient can bear it, with five drops to the ounce 
of compound tincture of iodine. With this solu- 
tion the uretha should be washed out about every 
two hours; taking care to have the water just as 
hot as it can be borne, as the organisms cannot 
stand heat; it attenuates them and makes the case^ 
run a mild course. 

I might say here that some of the most severe 



HYGIENE AND NURSING. 83 

forms of conjunctivitis that I have ever seen was 
produced from gonorrhea, and it is very generally 
conveyed by the hands of the patient to his eyes; 
therefore the patient should be very careful to 
keep clean hands, and also he should use care not 
to convey the disease to others. 

In women the disease as a rule does not give 
them the same amount of trouble as it does men, 
but sometimes the organisms will find their way 
into the womb and produce severe prostration and 
get out into the fallopian tubes and produce what 
is called pus tubes which is quite a serious condi- 
tion. Women from this cause have not unfre- 
uently lost ther lives. 

DIARRHEA. 

Acute diarrhea may be excited by the character 
of the food taken, or impure water; or it may be 
excited by unhealthy secretions poured into the 
intestines; or it may be due to atmospheric in- 
fluences. Sometimes it appears in epidemic form. 
When that is the case it is evidently due to some 
form of micro-organism. Its symptoms are thirst 
and uneasiness about the bowels; griping pain in 
the bowels, usually there is some pallor of the face 
and a slight debility, and frequent fluid evacuations, 
which sometimes becomes colorless. Tn some cases 
the patient is sick at the stomach and has a coated 
tongue. A diarrhea is an effort of nature to get 
rid of some impurity or noxious substance from 
the system, and appears in a number of diseases, 
and when appearing in other diseases is regarded 
as a mere symptom. The disease is much more 
common in summer than it is in winter. 



84 CARE OF THE BODY IN HEAI/fH AND DISEASE. 

The proper treatment is to take a mild purgative 
and if the case be stubborn to wash the bowels out. 
The patient should be confined to a fluid diet, and 
in cases where the diarrhea is simple, and is the 
disease alone itself, this treatment generally would 
be sufficient to affect a cure. 

DISENTERY. 

The symptoms of this disease are frequent and 
painful passages of mucuous mixed with blood. 
The passages are accompanied by a straining and 
bearing down, which is very characteristic of the 
disease. In the acute form the patient is thirsty, 
restless, and has a fever, and in severe epidemics 
is usually prostrated very much. In the severe 
acute form the disease is often ushered in by a chill. 
The fever is not usually high, and it is not often 
that the patient has a rapid hard pulse. In mild 
cases the pulse is not very much affected, and 
the temperature only slightly raised. Pain is 
always present to some degree. It has its seat in 
the large bowel, and is tender on pressure. The 
discharges are very small in quantity, and in some 
cases highly offensive, and resemble washings of 
meat. 

Contrary to what many think, disentery is a dis- 
ease of constipation. The patient is bound and 
the discharges come from the lower end of the 
bowels, which is the seat of the disease. The 
disease is due to a micro-organism and finds a suit- 
able place for development on the mucuous mem- 
brane of the large intestine. Isolated cases of 
disentery are usually soon recovered from, but in 
the epidemic form of the disease the mortality is 



HYGIENE AND NURSING. 85 

frequently considerable. The evidence is rather 
in favor of the theory that the organism is carried 
about in the air. Some think that it is in the water, 
and it might possibly be in some cases. 

As to the nursing, the patient should be kept 
quiet in bed, and in severe cases not allowed to get 
out of bed. His bowels should be washed out with 
warm water two or three times a day; he should 
have good cooling drinks like lemonade, and an 
exceedingly light diet in the fluid form, as milk 
and broth. 

CHOLERA-INFANTUM . 

As the name implies, cholera infantum is a dis- 
ease of infants. It begins with diarrhea, and the 
little child soon vomits, but as the case progresses 
and the patient gets weak the vomiting gives way 
to diarrhea. The discharges are colorless, or yel- 
lowish or greenish. The child is usually thirsty 
and has some fever. The disease sometimes runs 
a rapid course and kills the patient in th r ee or four 
days ; but generally it continues for weeks or months. 
The disease is undoubtedly due to a micro-organism 
generally brought into activity by improper feeding. 
In the latter stage of severe cases the child becomes 
much amaciated, is very restless, and makes plain- 
tive cries, and has rolling of the head, strabismus 
and coma. 

The mortality of cholera Infantum is very high. 
Thousands die every year in our cities and large 
towns from the disease. The hygienic treatment 
is of very great importance. If the patient is in 
an ill ventilated, hot situation, a change to a cool 
healthful climate is desirable. The diet is of very 



86 CARE OF THE BODY IN HEALTH AND DISEASE. 

great importance. Sometimes when sweet milk 
disagrees, buttermilk, sour with ice in it suits well. 
No solids whatever should be given. The bowels 
should be frequently washed out. 

CHOLERAMORBUS. 

The attack is characterized by spasmodic pains 
in the abdomen, cramps in the legs, rapid loss of 
strength, and vomiting and purging. That thrown 
up from the stomach and cast off from the bowels 
are both liquid and contain considerable amounts 
of bile. The micro-organism has been found in 
the discharges, which is supposed to be the cause 
of the disease. When the disease is at its height 
there is cramps in the calves of the legs, and some- 
times they produce hard knotty masses. The dis- 
cbarges have a foul odor, and the vomiting is con- 
stant. The thirst is intense, the skin is cool, but 
the duration of the disease is not long. In a few 
hours, or at the most a day, the symptoms yield 
to treatment and the patient speedily regains his 
health, but in rare instances the disease is rebelious 
to treatment, and the patient gradually sinks. 
Fluid diet, with rest in bed comprises the hygiene 
for this disease. 

JAUNDICE. 

The characteristic feature of this disease is a 
yellow skin, and yellowness of the whites of the 
eyes. The patient is usually depressed in spirits, 
and his circulation is depressed; in other words the 
heart beats slower than in health. The patient 
is constipated, and the discharges look very much 



HYGIENE AND NURSING. 87 

like clay in many instances. He generally has no 
fever; he has little or no appetite. 

Sometimes jaundice is a symptom of other dis- 
eases, and often of a serious nature, but for the 
most part it is owing to the bile being improperly 
conveyed from the liver; so instead of it being 
poured into the intestine as it should be, it finds 
its way into the blood, and produces the symptoms 
just described. It usually yields to treatment fairly 
well. The patient should be placed at rest and fed 
on fluid diet ; the constipation overcome wdth purg- 
atives, and very generally he will soon be convales- 
cent. 

CIRRHOSIS OF THE LIVER. 

Cirrhosis of the liver, the organ is diinmished in 
size and is dense and hard, and exhibits granula- 
tions of various sizes, separated by bands of fibrous 
tissue. 

One of the chief characteristic symptoms of the 
disease is a dropsy confined to the abdominal cavity. 
On careful examination the region that in health 
is dull on percussion is diminished in this disease. 
As the disease advances w r e have a marked loss of 
flesh and strength. Sometimes jaundice cachectic 
appearance with sunken features; hemorrhages 
from the nose, mouth, and from the stomach, are 
some of the symptoms of the disease. The appe- 
tite and digestion are poor, and the patient grows 
gradually w^orse and worse. Very little can be 
done for this strange disease, for the nature of the 
disease makes recovery impossible. 



88 CARE OF THE BODY IN HEAI/TH AND DISEASE. 
ACUTE BRIGHTS DISEASE. 

This disease is essentially of an acute character. 
After exposure to wet or cold a fever sets in. The 
patient often vomits and has pain in the region of 
his kidneys. His eyelids and face become puffy 
and swollen, and very soon a swollen condition of 
the skin is observed, especially in the extremities. 
The urine contains a large amount of albumen. 
The patient has a moderate fever, the pulse are 
usually quick, tense and full. Nausea and vomit- 
ing are a common occurrence. These symptoms 
last for several weeks. When in favorable cases 
they begin to abate. The temperature becomes 
normal, and the skin moist. The dropsy gradually 
disappears. The quantity of urine largely increases, 
and the albumen gradually disappears, but this 
is not the invariable issue. The disease often 
gradually lapses into a chronic form. The recog- 
nition of the disease is readily effected. The puffy, 
pale face, the dropsy, the albumen in the urine, 
with the tube cast, form a group of symptoms so 
peculiar to this disease that a physician with ability 
would very rarely mistake it. 

The nursing in this disease is highly important. 
The patient should be placed on a milk diet and 
kept on it for weeks. He should be kept perfectly 
quiet and giv r en large quantities of sulphate of 
magnesia. He should not be allowed to eat any 
solid food until a thorough test is made of the milk 
diet. 

CHRONIC BRIGHTS DISEASE. 

>Symptoms of chronic Brights disease are frequent 



HYGIENE AND NURSING. 89 

desire to void the urine, swelling of the extremities 
and the face, pallor and general debility; headache 
located in the back of the head; large quantities of 
albumen in the urine. 

There are few diseases which alter the character 
of the blood like chronic Brights disease, and it 
generally tells in the patient's face. The experi- 
enced physician can often pretty well tell in ad- 
vanced chronic brights disease, what ails the pa- 
tient by seeing his face. Yet there are other cases 
not so clear. In the vast majority of cases of chronic 
brights disease, the patient goes on from bad to 
worse and gradually sinks. It is thought by some 
that entire recovery is not impossible, but it does 
not often occur. The patient's life may be pro- 
longed by proper feeding and nursing. The pa- 
tient should be allowed to rest and kept for the 
most part, on a milk diet. He might be allowed 
broth, and occasionally a little solid food. 



90 CARE OF THE BODY IN HEAI/TH AND DISEASE. 



CHAPTER VII. 

SURGERY. 

The subject of surgery has always been more 
or less important ; but since there has been so many 
advances made in the treatment of wounds and 
in the mechanical skill in doing operations, it is 
vastly more important than formerly. 

In very ancient times surgery was done by the 
barbers, and later when it assumed the dignity of a 
profession it was often difficult to get operations 
of a hazardous nature done, and many persons 
died for the want of surgical aid. And even we 
read of operations being done by the patients them- 
selves. In the seventeenth century a man by the 
name of Jean Dot, a blacksmith, of Amsterdam, 
made a knife and cut a stone out of his own bladder 
successfully by the suprapubic method, as large 
as a hen's egg. The stone and the knife and a por- 
trait of the operator can be seen to this day in the 
museum of Lay den, but at the present day if a 
man is a little anxious about an operation he can 
generally get it done. It is not many years since 
ovariotomy was questioned, and men were often 
allowed to die with stone in the bladder but a few 
decades ago. The operation of appendicectomy 
is not more than 16 or 18 years old. Removing 
stones from the gall bladder is only 12 or 14 years 
old. Hysterectomy was not heard of until for 
the last few years. But now all these operations 



SURGERY. 91 

have been done thousands of times, and there are 
surgeons everywhere waiting for work to do. 

In order to enlighten the public on the object 
of operations I will quote a piece from Erichsen's 
Science and Art of Surgery of University College 
London : 

"By a surgical operation is meant a manual 
or mechanical process undertaken by the surgeon 
for the remedy of deformity, congenital or acquired ; 
or for the cure or relief of a patient suffering from 
those effects of injury or disease that are incurable 
by constitutional or ordinary local treatment, or 
in which such treatment would be too slow in af- 
fecting the desired results. A surgical operation 
may be necessary for the following objects: 

First, remedying or removing congenital defects 
and malformations, as hair lip, clubfoot, or super- 
numerary fingers or toes. 

Second, remedying acquired defects and deform- 
ities, as in the closure of fistula, the restoration of 
lost parts, and the corrections of distortions of the 
limbs. 

Third, the removal of foreign substances from 
the body, as in the extraction of a bullet or calculus. 

Fourth, the repair of the effects of injuries as 
in the treatment of certain fractures and disloca- 
tions. 

Fifth, the removal of parts that have been so 
disorganized by the effects of injury that their 
vitality is lost, or that their continued connection 
with the rest of the body would be a source of dan- 
ger, as in amputation for frostbite or mangled 
limbs. 

Sixth, the removal of diseased structures that 



92 CARE OF THE BODY IN HEALTH AND DISEASE. 

interfere with the utility of an organ or part, as in 
the extraction of a cataract. 

Seventh, the removal of the diseased structures 
that seriously inconvenience the patient, or that 
remotely threaten life, as in the exterpation of 
tumors, simple or malignant. 

Eighth, rescuing a patient from immediate and 
inevitible death, as in tieing a bleeding artery, 
opening the windpipe in laryngeal obstructions, 
relieving an overdistended bladder, or dividing 
the stricture in strangulated hernia. 

Operative surgery is but the application of man- 
ipulative methods to the relief and cure of injury 
and disease. Like every other art, be it manipula- 
tive, plastic or imitative, it can be carried only to 
a certain point of excellence. An art may be mod- 
ified, it may be varied, but it cannot be perfected 
beyond certain attainable limits, and so it is and 
indeed must be with that of surgery. 

There cannot always be fresh fields for conquest 
by the knife. There must be portions of the human 
frame that ever will remain sacred from its intru- 
sion; at least in the surgeon's hands. That we 
have neaily if not quite reached these final limits 
there can be little question. When we reflect that 
every large artery in the human body up to the 
aorta itself has been repeatedly ligatured, that 
each of the six large articulations and many of the 
smaller bones have been resected, that the ampu- 
tation of each limb up to the shoulder or hip joint 
is a matter of ordinary surgical occurrence; that 
large tumors, having the most intricate anatomical 
connection have been removed from every surgical 
region in the body, from the base of the brain to 



SURGERY. 93 

the lowest organ in the pelvic cavity; that the 
larynx, the spleen, the kidney, the pregnantuterus, 
and even portions of the stomach have been suc- 
cessfully removed. When we reflect on triumphs 
of the surgeon's art that are expressed by operations 
such as these, we can scarcely believe otherwise 
than that little remains for the daring of the boldest 
to devise, or the skill of the most dexterous to ac- 
complish. In the extension of that art, in the 
direction of its operative department, and that 
the surgeon must in future be content to repeat 
though possibly in a modified and improved man- 
ner, those operations that have been inaugurated 
by the genius and perfected by the skill of his pre- 
decessors. " Since this was wTitten the entire 
stomach has been successfully removed on several 
occasions, and several feet of the intestines have 
been successfully removed a number of times, and 
even the heart has been sutured for wounds on 
several occasions. 

The state of the patient's health often influences 
the success of an operation. Even more sometimes 
than the severity of the operation itself. The age 
of the patient influences the operation to a very 
great extent. Persons over seventy years old 
rarely survive a capital operation; even removing 
stone from the bladder in men over sixty is not 
often successful. Very fat persons bear operations 
very badly. Persons of on irritable and anxious 
mind bear operations badly. Those also of a feeble 
circulation do not withstand operations well. Per- 
sons with valvular disease of the heart are bad 
subjects for operation. Those with Bright Disease 
usually die under capital operations. Those with 



94 CARE OF THE BODY IN HEALTH AND DISEASE. 

diabetes mellitus do not often withstand an opera- 
tion of a capital nature. Patients with a high 
temperature should not be operated upon except 
in the so-called surgical emergencies. Individuals 
of sound constitution who have never been impaired 
by excesses of any kind; whose habits have been 
temperate, and who have been well fed; whose 
minds never have been strained over the anxieties 
of business, or the labors of a professional life, and 
who have spent their lives in rural occupations, 
and in the pure air of the country, are in a far more 
favorable position to bear operations of magnitude, 
than the man who is worn out by active and unceas- 
ing business vocations, or professional men whose 
nervous system is exhausted by anxious labor, 
and vastly more than the poor inhabitant of the 
large and densely peopled city who have from early 
childhood breathed impure and a fetid atmosphere; 
whose food consists of the refuse of the shops, and 
whose nervous system is exhausted in the daily 
struggle for a livlihood. 

It is quite certain within the rural districts that 
there are many persons die now from diseases that 
could be cured by a surgical operation. On the 
other hand, in the large cities and large towns there 
are many operations done unnecessarily and even 
harmful to the patient. The great anxiety for 
fame among the great army of surgeons at the 
present day, and the greed for money, prompts 
many of them to do operations unnecessarily. A 
patient that is the subject of a surgical disease 
should endeavor to consult an enlightened' and 
honest surgeon; one not over-anxious for the fame 
of doing many operations, nor greedy for money. 



SURGERY. 95 

It appears that many surgeons at the present day 
endeavor to build a reputation by the large number 
of cases they have operated on. They in this way 
become completely carried off with the use of the 
knife. There can be no doubt that conservative 
surgery or rather enlightened conservative surgery 
is a great blessing to humanity, but the great ten- 
dency of the day is for physicians to become spec- 
ialists, and a great number of them take surgery 
as their specialty. 

It would be surprising to many persons living 
in the country to know the large number of opera- 
tions that are done in all the large cities every day. 
The great craze to operate at all hazards is the 
chief fault of surgery. The clean hospitals and 
antiseptics methods of doing operations, and the 
facility with which the knife is used there is very 
little to condemn in it. As time is a great corrector, 
no doubt in time that fault will be corrected. That 
is doing unnecessary operations. 

GENERAL-NURSING. 

In the cities and many of the large towns, trained 
nurses are available; but in villages and in the 
country, the people generally have to do their own 
nursing; and if good nursing is a part of the cure, 
and it appears to me to be a very indispensable 
part, it is quite an important thing that the people 
be informed on it. To be a good nurse really re- 
quires an intelligent person. Women as a rule 
make better nurses than men. Where persons 
are not trained, if they be intelligent, it does not 
take them long to get at the essentials of good 



96 CARE OF THE BODY IN HEALTH AND DISEASE. 

nursing. Among the ignorant classes and those 
unable to employ nurses, it is almost impossible 
to carry out the principles of good nursing. In all 
contagious diseases, as smallpox, v Scarlet fever, 
Diphtheria and Measles, the attendant upon the 
sick as a nurse, should wear a clean white gown 
when in the sick room, and should change his cloth- 
ing and bathe very often. The gown worn in the 
sick room of contagious patients, should not be 
worn when out with other persons. 

Some of the important duties of a nurse is to give 
medicine exactly on time, be able to adjust the 
bed for the patient, know how to sponge or bathe 
the patient, to draw his water when necessary, 
give an injection by the bowels, wash out the stom- 
ach, apply poultices when necessary, and see that 
the food is prepared and administered to the pa- 
tient according to the order of the physician in 
attendance. 

The place for a sick person, if very much indis- 
posed, is in the bed. Many sick persons when 
they should be in the bed, consume their strength 
by exercise, and should the disease prove of a seri- 
ous nature they have but little vitality remaining 
with them to withstand the disease. When in 
any doubt as to the nature of a disease, an enlight- 
ened physician should be called. 

The duty of the nurse or whoever attends to the 
patient, and it is best for one person alone to take 
charge of him, is to follow the physician's directions. 
All meddlesome neighbors, or gossiping visitors, 
no difference how well meaning they may be, should 
be ignored. They are to be found in nearly all 
communities claiming to understand the deep 



SURGERY. 97 

mysteries of medicine, when the health and the 
life of the patient is often at stake. As people 
become more enlightened they will be less inclined 
to put in their judgment against those that make 
it a life study. It is generally conceded that per- 
sons suffering from any severe disease, should be 
in a well ventilated, clean and very light room. 
Light exercises a good influence upon the sick. 
The ideal room is not often attained; especially in 
rural districts. Of course during the hot summer 
days the rays of the sun should be excluded off 
the patient. Light never should be permitted to 
fall directly into the patient's eyes. Plenty of 
light can be admitted into the room and the patient 
screened from the light falling directly into his 
face. Doors and windows should be managed so 
as to exclude draughts. The best way to ventilate 
in winter is to open a window in a hallway or ad- 
joining room, that the cold air may be modified 
before it reaches the patient. Unless there are 
no other means of heating, oil stoves should not 
be allowed on account of their quickly contamina- 
ting the air. Oil burners when they are turned 
low, are more poisonous than when allowed to burn 
free; so when a night lamp is necessary it should 
be allowed to burn freely. 

A very good way to cool a room in the summer 
time is to hang up wet sheets in the room, or place 
a large block of ice in a basin near the bed of the 
sick. 

Dry air is best for rheumatism and moist air for 
croup. Moist air may be obtained by keeping a 
kettle boiling. As to the furniture of the sick room, 
every piece that is not needed should be removed. 



98 CARE OE THE BODY IN HEALTH AND DISEASE. 

In contagious diseases no pieces of carpets, curtains, 
nor stuffed furniture should be allowed in the sick 
room, as these often retain the germs and may be a 
means of spreading the disease. Cleanliness should 
be maintained to the utmost throughout. A pat- 
ent sweeper or a wet cloth over a broom is best to 
sweep the carpets with, the dusting should be done 
with a damp cloth. 

Medicine bottles should not be scattered around 
in the room, nor anything that suggests sickness. 
They should all be kept out of sight. The attend- 
ant should carefully read the directions every time 
the medicine is administered, to make sure that 
there be no mistake. 

The nurse should give medicine strictly on time, 
but the patient should never be awakened to give 
medicine under any circumstances. 

The food should be given with the same regular- 
ity as medicine. Food should not be allowed to 
remain in the sick room, especially such as milk 
and fluid foods, as they absorb poisons and foul 
odors. Except in mild illnesses feather beds should 
not be used. It is often very difficult to keep them 
from having an uneven surface, and they prove an 
exciting cause of bed sores, which is often quite 
annoying, not only to the patient, but his physician 
and nurse. 

For summer a cotton, shuck or straw mattress 
makes a good bed, with a blanket spread over it, 
and for very cold weather there is nothing equal to 
wool most simply made up and kept free from wrinkles 
and rolls. The undersheet should be stretched 
tightly across the mattress and tucked under it-— 
not stuffed around it as is ordinarily done. All 



SURGERY. 99 

bed coverings should be light in weight in order 
that the patient may breathe freely. Heavy cov- 
erings are not proportionately warm. Two light 
blankets are warmer than one extra heavy one on 
account of the air being between them, acting as 
a non-conductor of heat. Where the bed is a double 
one, and in the absence of two beds in the room, 
the patient should be removed from one side of the 
bed to the other so that he may occupy one side 
of the bed during the day and the other side during 
the night, so that the bed may have some chance 
to be aired and freed from impurities; 'though it 
is best to have two beds for a sick person, and 
change the patient night and morning from one 
to the other. Well persons should not sleep with 
the sick, inasmuch, it is very disagreeable and it 
may serve to convey the disease to the healthy. 

The patient sometimes complains of the sound 
of his own heart-beats; in other words theTsound 
is conveyed to the pillow on which he rests. In 
this case a hair pillow should be procured if possi- 
ble. A hair pillow does not conduct the sound so 
freely, and it is also very agreeable to fever patients. 

The proper way to clothe a sick person is the 
simple way. Very generally a night-gown is suf- 
ficient. This makes changing of the clothing easy, 
and saves wearying of the patient. 

In order to change clothing on one that is sick 
without bringing him to the sitting posture, and 
without undue exposure, the soiled clothing should 
be gradually worked up as far as the shoulders then 
one sleeve should be slipped off ; now the arm should 
be placed in the sleeve of the clean one; now the 
other arm should be dealt with the same way; then 



L.ofC. 



IOO CARE OF THE BODY IN HEALTH AND DISEASE. 

the gown should be placed over the head and grad- 
ually worked down beneath the back. 

For a very weak person who cannot bear to be 
moved in the least the gown should be slit up all 
the way down the front and placed on like a child's 
apron, with the wrong side in front. It is necessary 
in dressing a person with a broken arm or leg, to 
place the garment on the injured limb first; when 
undressing, disrobe the well limb first. Many 
intelligent persons entertain an unfounded preju- 
dice against a full bath for invalids but it is a fact 
that there is a great deal of waste constantly coming 
off from the sick person by the way of the skin; 
and cleansing of the skin keeps this waste from 
being reabsorbed, and often is a factor of no little 
consequence in the patient's recovery. When the 
bath is properly given no fears need be entertained 
that the patient will take cold. In many instances 
it is desirable to bathe the patient every day. To 
accomplish a full bath, the patient's clothing should 
be removed, he should now be placed on a blanket. 
To do this turn him on his side with his back to 
you. Now the blanket should be well placed under 
him, then he should be rolled back upon it until 
he lies on his other side. Now the nurse goes to 
the other side of the bed and straightens the blanket 
under him in the same manner as changing the 
undersheet. Now he should be covered with a 
blanket; the nurse will now expose one portion of 
his body at a time and wash and dry thoroughly. 
This should be covered and another part exposed 
and dealt with in a like manner, and so on until 
the bath is completed. 



SURGERY. IOI 

In nursing, the care of the toilet embraces many 
little details. If the patient be a lady, the hair 
should be braided from the start so that it will not 
become entangled. The mouth of the patient re- 
quires care; especially in low fevers. The impuri- 
ties that often accumulate on the teeth and gums, 
are sometimes difficult to remove. A swab should 
be made by a soft cloth wrapped around the end of 
a stick. There are many forms of mouth washes 
that are very efficient. The nurse can easily pre- 
pare one. Equal parts of lemon juice, glycerine 
and water makes a good wash. The swab should 
now be dipped into this wash and the mouth gently 
but thoroughly cleansed. 

Dry lips should be anointed with some bland 
oil. The nose should be cleansed of its secretions 
to prevent picking at the nose which is apt to occur 
in typhoid fever. The nose may be bathed with 
listerine, and then anointed with some bland oil. 
The finger and toe nails should receive attention; 
they should be trimmed frequently, as it contri- 
butes to the comfort and appearance materially. 

Bed sores are often a troublesome complication 
in low fevers and other protracted illnesses. The 
nurse should carefully examine on the hips and 
other bony parts of the body, for any indications 
of them. When any indications appear of bed 
sores a teaspoonful of alum placed in a half pint 
of alcohol will be found a very useful thing to bathe 
them in, and will often prevent their forming. This 
treatment hardens the skin and makes it more 
resisting to the exciting influence of the sore. The 
patient should be changed often from one position 
to another. This will be found to be useful in pre- 



102 CARE OF THE BODY IN HEALTH AND DISEASE. 

venting these troublesome bed sores. Moisture 
contributes to their formation, and for that reason 
they should be kept as dry as possible. After the 
application of the alcohol they should be dusted 
with boracic acid. Should they break down into 
an open ulcer the physician in attendance should 
be notified so he may apply his favorite remedy. 
The duty of a nurse is to endeavor to preserve 
the strength of the sick in his or her charge, knowing 
that the strength of the patient means the life of 
the patient. For that reason he should not be 
asked unnecessary questions; for to extremely 
w T eak people even thinking and talking is very 
exhausting. Hearing would appear to be more 
acute in the sick than it does in the well, therefore 
persons should not be allowed to whisper in the 
sick room. The patient strains himself in the effort 
to hear what is said and often it arouses his suspic- 
ions. The talking that is necessary in the sick 
room should be done in subdued tones so that the 
patient can easily hear all that is talked about with- 
out being shocked by a loud voice. In low fevers 
the patient often gets into a stupor, and it is often 
the case for persons to try to arouse them by calling 
them aloud. That should not be done at all. A 
very efficient way to get a patient out of a stupor 
is to put on an ice cap or apply cold water to the 
back of the head. When people are very low they 
should not be raised to a sitting posture for no oc- 
casion. In such cases the bed chamber should be 
made use of on all occasions. Raising the patient 
in extreme prostration may bring on heart failure. 
In such cases an invalid's cup for medicines, food 
and water should be used. 



SURGERY. 103 

The nurse should use care to see that the feet 
are always kept warm. Cold extremities is a pow- 
erful weakener of the heart's action. Where rub- 
ber water bags are not to be had, bottles filled with 
hot water, wTapped in a yarn blanket will serve 
the same purpose to keep the feet warm. 

Respecting visitors when people are extremely 
low, it is best to exclude them altogether; espec- 
ially sympathetic friends who mourn or recite stories 
of distress. Nurses during the doctor's absence, 
should keep a record of all occurrences of a peculiar 
nature that the patient may experience, and on 
his return should communicate it to him. 

In giving an injection or enema into the bowels 
the best instrument is the fountain syringe. For 
this purpose soap and water are commonly employed 
Pure soap like castile should be used, and should 
usually be made as warm as the patient can bear 
it. There are however, some exceptions to this 
rule. The injection of cold water in diseases with 
a high fever can often be made a means of reducing 
the temperature, and is in this way very useful. 

An adult person can usually take by injection 
from a half gallon to three quarts. The amount 
for children would have to be reduced in propor- 
tion to their age. The fourth of a pint for a little 
infant would generally be enough. Before the 
instrument is introduced into the bowels, if a bulb 
syringe be used, the bulb should be filled so as to 
free it from air; otherwise you may give your pa- 
tient a great deal of pain. 

The patient should lie on his side to receive an 
enema. 

The instrument should be introduced with care 



104 CARE OF THE BODY IN HEALTH AND DISEASE. 

and gentleness. If the injection causes pain the 
operation should be suspended for a few minutes, 
until the pain ceases, and then proceed again with 
the injection. When the operation is complete a 
folded towel should be placed against the parts 
and held for two or three minutes so the injection 
may be retained. The instrument should always 
be cleansed thoroughly after each injection to keep 
it in good condition; and it should not be placed 
back in the box, but hung up at some convenient 
place. There are a number of instruments on sale 
of late years, constructed to give an injection in a 
sitting posture. They do very little good. The 
patient should always lie down to have an injection. 
In cases of throat and lung diseases inhalations 
are sometimes prescribed. The common Japanese 
teapot is suitable for the patient to take these in- 
halations out of, boiling water is poured into the 
teapot and the medicine prescribed put into the 
water. The lid is placed on the pot; the patient 
is now directed to place his mouth over the spout 
and breathe through it in a quiet way. After 
taking five or six breaths he removes his mouth 
from the pot and breathes in the natural way, for 
a minute or two and then repeats the breathing 
from the kettle again. This treatment should 
last from ten to twenty minutes. In fevers, appli- 
cations of ice are sometimes highly useful. A 
rubber ice cap is manufactured for the purpose of 
holding the ice. In case of necessity one should 
be procured. It should then be partially filled 
with crushed ice and pressed to get rid of the air. 
This renders it comfortable to the shape of the 
head. A piece of cloth should be placed between 



SURGERY. 1 05 

the cap and the patient's head, as tne cap may 
sweat. To crush ice, wrap the lump in a coarse 
towel before breaking. This prevents the pieces 
from flying around when broken. When a rubber 
water bag is needed it should only be partially 
filled; then the excess of air should be squeezed 
out in the same way as in filling the ice cap. In 
order to avoid burning the patient the water bag 
should be wrapped in a yarn blanket. 

When a patient is able to sit on a chair for a few 
minutes undressed, a blanket should be pinned 
around his neck and brought around his whole 
body; tucking it under to exclude the air. 



I06 CARE OF THE BODY IN HEAI/TH AND DISEASE. 



CHAPTER VIII. 

THE PROPER CARE OF YOUNG CHILDREN. 

§j Very generally little children when they are 
healthy, if they are sensibly cared for they will 
remain healthy. The vast majority of illnesses 
amongflittle children is due to their improper treat- 
ment by the nurse or parents. As such a great 
proportion of this sickness is brought about by 
the feeding of the child, I will treat of that first. 
The stomach of a new born infant is only capable 
of holding two or three tablespoonfuls of milk. 
This fact should be impressed upon the mother or 
nurse, for most persons would think that a child's 
stomach would hold very much more than that. 
A large number of the cases of diarrhea, children 
with painful stomachs, that cry and fret and give 
so much trouble, is owing to their nursing too much. 
It would be a very hard matter to lay down any 
strict rules as to how long or how often the child 
should nurse. In the first week every hour and a 
half or two hours would be often enough. And 
the second and third weeks, every two hours. From 
the third to the sixth week, they may be allowed 
to nurse about every three hours. In the mean- 
time they should not be allowed to nurse but a 
short while at a time. Placing them to the breast 
to appease them when they cry is often overfeeding 
them. Children, like grown people in some re- 
spects, can form habits that are hurtful to them, 



THE PROPER CARE OF YOUNG CHILDREN. 107 

and in the matter of nursing that is often the case. 
Very large and robust children require more than 
delicate ones; and if the mother be healthy the 
best food for her offspring is her own milk that 
nature has provided. 

In feeding artificially it is safest to consult a 
physician; for what agrees with one child may 
not agree with another. Cows milk is certainly 
next to mother's milk for feeding the child. The 
milk should be obtained from a healthy cow, and 
milked with a great deal of care so that it may be 
perfectly clean. There is an idea prevailing that 
boiled milk is better than raw or fresh. My expe- 
rience has taught me that unboiled milk, if it is 
clean and used fresh from the cow, is far superior 
to boiled milk. Cooking of milk hardens some 
of the constituents of it; and as the child's stomach 
is always a very delicate one it very often disagrees. 

When a child is doing well, resting well at night, 
and gaining in weight, it is not safe to make any 
radical change in its feeding; and I might say here 
that the changes in feeding should be made gradual 
whenever possible. When he is losing in weight 
or rests bad at night, or has colicy pains, his food 
should be carefully looked into; the amount he is 
taking, the health of the mother, or if cow's milk 
be used, wiiether it is used fresh or allowed to stand 
before use, or whether it is milked with the proper 
precautions, for that is a very important thing. 
The child that is properly fed, at the proper inter- 
vals will not thirst for the breast at improper times, 
save when his appetite has been perverted by im- 
proper feeding. The practice of nursing the child 
every time it cries should be condemned. Intelli- 



108 CARE of the body in health and disease. 

gence should suggest that there are many other 
causes of discomfort aside from hunger. The 
clothing may be too tight, or it may be 
damp. The child may be constipated, or too 
much gas may collect in the bowels. In the 
last named instance, while feeding might appear 
to afford relief momentarily, it really adds gravity 
to the case. If the child is distended about the 
bowels and cries, it is likely that there is too much 
gas in the bowels. A good way to get rid of these 
gases is to inject from a quarter to a half pint of 
warm water into the bowels, and repeat it several 
times. This will usually give relief. Glycerine 
may be added to the w r ater; say about a teaspoon- 
ful to the injection. As a very general rule medi- 
cines should be kept out of a little baby's stomach. 
Almost all the soothing syrups, cordials, patented 
and proprietary preparations prepared for children 
contain opium in some form, or some other deadener 
to the nervous system, which are not good drugs 
for a little child. The injections of soapy water 
will relieve constipation as a rule. In case it fails 
a teaspoonful of rochelle salt may be given in a little 
water and repeated in three hours until the bowels 
move. Castor oil is sometimes used, and may do 
very well in some cases. Cases of obstinate consti- 
pation requires the attention of a physician, A 
great deal of care should be used with a mother's 
breast when she nurses her child, to keep it abso- 
lutely clean; for whenever there is uncleanliness 
micro-organisms abound. They often gain en- 
trance to the child's stomach, and they may produce 
sore mouth, diarrhea, cholera infantum, and other 
disorders of the digestive organs. 



THE PROPER CARE OF YOUNG CHILDREN. 109 

Before and after each nursing the nipples of the 
mother should be cleansed with warm water. When 
the child is fed by the bottle the infant should have 
two bottles to suck from, and two black nipples. 
Long tubes are objectionable on the score of un- 
cleanliness. Wheij the child is using one bottle 
the other with its nipple should be kept in water 
with washing soda in the water. The nipple should 
be thoroughly washed after using each time, both 
inside and outside, so that there will be no milk 
left to sour. 

From nine to twelve months is a suitable time 
to wean children ; but if this occurs in the hot sum- 
mer months it is better to wait until the approach 
of cold weather, as changing off on other diet often 
sets up diarrhea and cholera infantum, which car- 
ries off so many little infants. Sudden weaning 
is not proper. The child should be at first, in 
process of weaning, allowed to nurse some and 
take some cow's milk. This should be carried 
out for at least a month before the breast is entirely 
withdrawn. Cow's milk is the food for a child for 
the first three months after he is weaned; then 
animal broths and a little well cooked rice may be 
added. Later on a half done egg poached, with 
a little butter occasionally, will give strength to a 
child. The child should be at least three years 
old before he is allowed to take the general table 
food; and then it should be properly prepared, 
and of the most digestible character. A very 
young child occasionally needs a little water, which 
may be given out of a spoon. Children are some- 
times fretful for want of this. During the second 
summer a great deal of care should be exercised 



110 CAR^ of the body in health and disease. 

in feeding the child. Raw fruits should not be 
allowed. A little cooked fruit occasionally may 
be allowed. If the proper care were taken in feed- 
ing the child the second summer it would not often* 
give more trouble than the first. The clothing 
should conform to the season. In w^arm weather 
it should be cool and light. Light flannels 
should be worn throughout the year, next to the 
skin; 'though it should be the lightest obtainable 
in warm weather. The clothing should be made 
to fit rather loosely to give room for the develop- 
ment of the various organs. Most children, if the 
temperature of the water is comfortable, enjoy a 
plunge bath, w T hich may be given daily; but should 
the child be a delicate one he should be sponged 
over with tepid or warm water, after which care 
should be taken to dry him good. Sometimes 
children are frightened at the plunge bath. A 
sheet may be folded and the baby placed upon it 
and carried down slowly into the w^ater. The 
child should be put to bed rather early, and in order 
that he may not be fretful there should be a fixed 
time to put him to bed, so that he will form a habit 
of going to sleep at certain hours. This will con- 
tribute not a little to his resting easy of a night. 
The child should be taught to go to sleep without 
being rocked; and when he forms the habit he 
will not require any rocking. 

Infants, like grown people, can form habits that 
exert no little influence over them, either good or 
bad ones. Some children form habits of crying, 
and it is very difficult when once they do, to make 
perfectly quiet children out of them. A large 
quantity of sleep is a good thing for a child. They 



THE PROPER CARE OF YOUNG CHILDREN. Ill 

should never be kept up late at night. It often 
renders thern excitable and easily disturbed during 
the sleeping hours. The eyes of a child should be 
protected from strong light, whether he be asleep 
or not. Children should not be exposed to con- 
tagious diseases under the impression that they 
should have the necessary children's diseases, as 
they are sometimes called. 

SUMMER DIARRHEA IN CHILDREN. 

This disease is caused by a micro-organism. 
Some attribute it to teething. It is very doubt- 
ful whether teething has anything to do with it 
or not. The disease is more easily prevented 
than it is cured; especially when it has stood for 
weeks or months. Among preventive measures 
perfect cleanliness is of the first importance; of 
the child himself, or his surroundings. He should 
have plenty of pure air to breathe; he should be 
frequently bathed. His soiled napkins should be 
washed often, when diarrhea does exist, no matter 
to how limited an extent, washing of the napkins 
is obligatory. A nurse should also disinfect her 
hands, otherwise she may re-infect the patient. 
The diarrhea should not be treated as a trivial 
affair. A mild purgative may be given. A tea- 
spoonful of rochelle salt should be given and re- 
peated every three or four hours until it operates 
freely. In the meantime the bowels should be 
washed out about three times a day with tepid 
water. Should this prove inefficient a physician 
should be called who will carefully look into the 
diet and general management of the patient, and 
prescribe such remedies as are necessary. There 



112 CARE OF THE BODY IN HEALTH AND DISEASE. 

is hardly anything more important than attentions 
to diet in cases of this kind. There seems to be 
a considerable relation between artificial feeding 
and diarrhea, and for that reason children should 
not be weaned during the heated months of the 
year. 

When the baby must be placed on food other 
than what nature has provided, it should be given 
with strict cleanliness. In the case of breast fed 
babies the enforcement of all the rules of cleanli- 
ness of the mother's breast and the baby's mouth, 
should be enjoined. 

During the season of excessive heat children as 
well as adults, require less food and more water 
to maintain health. The child should not be al- 
lowed to nurse as long in hot weather as in cool. 
In case the diarrhea does not yield in a few days 
to medical treatment, if it be in hot weather, a 
change of climate sometimes is desirable. Should 
the change prove beneficial the child should be 
kept in the new climate until he fully recovers. 
Even when the child is very much prostrated from 
summer diarrhea, and when there is a high fever, 
they seem to do better out of doors in well shaded 
parks, or other shaded situations, during the day- 
time, than they do housed up. A child will usu- 
ally do better lying in a carriage or hammock than 
on the mother's lap. The heat of the mother seems 
to be injurious to it. 

When perspiration is excessive cotton or linen 
may be placed next to the skin. Sponge bathing 
should be had recourse to which quiets the little 
fellow, inasmuch as it is desirable for cleanliness 
sake. A little vinegar or alcohol may be added to 



THE PROPER CARE OF YOUNG CHILDREN. 1 13 

the water. Should the physician prescribe the 
plunge bath it is well to place the little fellow in 
water at about the body's temperature, and reduce 
it with cold water to 75 or 80 degrees fahrenheit. 
Ten to twenty minutes is long enough to give a 
bath of this character. The little fellow may be 
rubbed gently while in the water to assist the cir- 
culation of the blood. In severe cases of this dis- 
ease digestion is often entirely arrested so that 
the administration of food will prove harmful 
rather than good; and for that reason should be 
withheld until the child improves a little. 

The skin of the child should be kept dry and 
dusted with some of the dusting powders prepared 
for the purpose to prevent chafing. 

There is a very prevalent opinion among people 
generally that people should eat when they are 
very sick, even when they have no appetite. This 
opinion for the most part is erroneous. When 
nature removes the appetite if the removal be com- 
plete, at the same time it removes the powers of 
digestion, and it is generally vain to give food until 
a little appetite is secured; and such is the case 
with a little child. They do not often starve to 
death when the cause of the disease is removed. 
The patient will most invariably gain an appetite, 
and he should then be fed with discretion. 

After the patient is convalescing solid food should 
still be withheld for several days. The patient 
will not starve on fluid diet, such as milk and ani- 
mal broth. The diet is so very important in the 
treatment of these diarrheas it should receive 
equally as much attention in its administration 
as the giving of medicine. During the remainder 



114 CARE OF THE BODY IN HEALTH AND DISEASE. 

of the summer much care will still be required to 
prevent relapses, which are usually owing to errors 
in diet. 

THE NURSING OF CHOLERA INFANTUM. 

Cholera infantum is far less common than sum- 
mer diarrhea, but it is a very severe disease; the 
mortality ranges very high. It often begins with 
a diarrhea. The symptoms of it have already 
been described in this work. When any of the 
symptoms of Cholera Infantum make their appear- 
ance the physician should be called at once. Both 
the preventive and nursing care call for measures 
similar to those advised in summer diarrhea. In 
extreme cases bathing may have to be resorted to 
every hour, as it is accompanied by a fever. Cold 
cloths or an ice cap should be kept to the head 
continually. Should the body become cool, hot 
mustard baths should be made use of, after which 
the patient must be kept warm by placing around 
them hot water bottles or the hot water bag; care 
being taken not to burn the patient's flesh. 

THE NURSING OF WHOOPING COUGH. 

Whooping cough is a very contagious disease 
and is chiefly found among children. Young 
children are more susceptible to it than to any 
other contagion; and when it occurs during this 
stage of existence it is often a very serious disease. 
In the little infant it is often complicated with 
Broncho Pneumonia and Diarrhea. In the aged 
it is a very serious disease; for in this advanced 
time of life the blood vessels have lost so much of 
their resisting power they sometimes rupture and 



THE PROPER CARE OF YOUNG CHILDREN. 115 

prove fatal. It is not a dangerous disease after 
the fourth year, provided the child has a sound 
constitution. Delicate children are more liable 
to it than strong robust children. The earliest 
symptoms are very much like a cold. Redness of 
the eyes, discharge from the nose, with a slight fever 
and a cough, forms the chief symptoms of whoop- 
ing cough. It is usually some days or even weeks 
in some cases, before the peculiar cough is heard, 
which is characteristic of the disease. The cough 
comes off in paroxysms. They are at first rather 
mild, and fewer in number than later on in the 
disease. In severe cases they are always distress- 
ing. A single severe paroxysm may last two or 
three minutes, and be accompanied by a half dozen 
whoops, which appears to afford some relief. The 
nose often bleeds but the hemorrhage is usually 
slight; the patient often vomits. This is called 
the spasmodic stage, and lasts about one month, 
and increases in severity for at least the first two 
weeks, and then begins to decline in severity. To 
this rule there are many exceptions, for when the 
disease appears in winter it sometimes holds on 
for months. Paroxysms are often excited by 
draughts of air or eating anything that is cold, 
and are more frequent in the night than in the day, 
and in closed rooms than out of doors. Little 
children sometimes are completely overcome with 
the cough. In this instance they should be placed 
on their backs and cold cloths put to their heads. 
In nursing the patient he should be kept out of 
doors in the daytime as much as possible; but great 
care should be exercised that the patient is clothed 
sufficiently; and in very inclement weather, he 



Il6 CARE OF THE BODY IN HEALTH AND DISEASE. 

should retire altogether to his room, as taking cold 
intensifies the disease very much. Food must be 
given often and should be of a nourishing and very 
digestible character. Should diarrhea set in it 
should receive prompt attention, as this renders 
the nourishing of the child quite difficult. 

When the cough persists after the disease has 
run its course the child should be taken to some 
mild climate where the air is bracing. Second 
attacks of whooping cough do not often occur. 

THE NURSING OF MUMPS. 

The greatest number of cases of mumps are met 
with in children. This is also a contagious disease. 
It is, generally speaking, not a very serious disease. 
Complications are not very frequent. The most 
common complication is inflammation of the sex- 
ual organs. The symptoms are headache, pains 
in the back and limbs, and sometimes the patient 
complains of being chilly; there is some fever; a 
loss of appetite, and the patient sometimes vomits; 
pains about the ears, with swelling of the parotid 
glands. The pain is aggravated by swallowing 
any kind of an acid. This swelling referred to is 
just in front of the ears, and rather below. It 
may be on one side alone, but usually it is on both 
sides. This disease usually needs no medicine of 
any kind. If the case be rather severe the patient 
should be kept in bed. If the pain be severe about 
the parotid glands, cloths wrung out of hot water 
applied to them will give relief. 

The diet should consist of fluids alone. Solids 
usually give pain in chewing and swallowing. 



THE PROPER CARE OF YOUNG CHILDREN. 117 

NURSING OF MEASLES. 

In the nursing of measles the patient should be 
put to bed in a well ventilated room. The room 
should be well shaded to protect the eyes of the 
patient. The patient should not read on account 
of the condition of his eyes. The room should be 
kept with a moist air in it by boiling of a kettle 
of w^ater; especially in the case of children, as it 
enables them to breathe much easier. Many 
persons believe in packing on lots of cover to break 
them out, as they say, also they deprive them of cold 
water. While it is important to avoid draughts 
and keep the patient from being chilled, there is 
not a particle of use of anything but comfortable 
covers on, and the patient should be allowed all 
the cold water he wants. The tendency of the 
cold water is to hasten the appearance of the rash 
rather than to hinder it. The diet should be that 
of liquids, such as milk and animal broth; and even 
upon recovery, solid food should be gradually re- 
turned to. 

Severely inflamed eyes should be frequently 
bathed with a solution of boric acid. When the 
fever runs high an ice cap should be kept on the 
head. The feet should be kept warm. Woolen 
undergarments should be worn. As soon as the 
rash has disappeared the patient should take a 
warm bath daily, and the skin be oiled with olive 
oil to facilitate the peeling of the little scales that 
come off of the skin. The patient should be quar- 
antined four weeks from the beginning of the at- 
tack. A separate set of dishes should be kept for 
the sick room and boiling water poured over them 



Il8 CARE OF THE BODY IN HEALTH AND DISEASE. 

before they are washed in order to destroy the 
germs. Handkerchiefs or cloths that are used by 
the patient should be burned. Nurses should not 
mingle with others until they have changed their 
outside clothing. When the child is convalescing 
it should be kept in a comfortably warm room 
until every symptom of the disease has disappeared. 
A second attack of measles is not common. 

In the nursing of German measles, which is dis- 
tinctly another 'disease, the same principles hold 
good that have just been laid down for measles. 
Very little medicines, if any, are needed for either 
one. 

chicken POX. 

The eruption usually appeal's first upon the face 
and scalp in chicken pox, in widely scattered spots, 
spreading slowly over the body. It usually appears 
in the form of a bleb with a little watery fluid in it. 
Sometimes the skin may be nearly covered on some 
parts of the body. Chicken pox is contagious and 
also goes in the air. It is a very trivial disease, 
and does not often result in mischief. 

Children should not be sent to school. The 
body should be kept clean and the patient not 
allowed to scratch the blebs, as that may cause 
them to inflame. It is unusual for any one to have 
the disease more than once. 

THE NURSING OF SCARLET FEVER. 

From the very beginning of the attack, no differ- 
ence how mild the disease may be, the patient 
should be separated from the rest of the family. 
Disinfection of the bed, the patient's clothing, and 
discharges from the patient and the nurses hands 



THE PROPER CARE OF YOUNG CHILDREN. 119 

should be rigidly enforced. The best bed is a flat 
cheap mattress which may afterwards be burned. 
Scarlet Fever is a disease with a number of com- 
plications. Kidney disease being the most common. 
During the progress of the disease the patient should 
be allowed plenty of water, which, to a considerable 
extent, prevents the kidney complication. 

As to the diet, it should be strictly fluid, consist- 
ing of milk and animal broth. While the fever 
lasts the room should be kept cool. When the 
fever runs high an ice cap should be kept to the 
head. After the fever and rash have disappeared 
the patient should have a warm bath daily. It 
takes from six to eight w^eeks for the scales to be 
completely shed. The throat is sometimes very 
sore in swallowing. An ice bag placed under the 
throat contributes materially to its relief. The 
mouth and nose should be kept clean in order that 
the inflammation may not extend into the ears 
and cause deafness. When the patient is recov- 
ered disinfecting baths for the patient and the 
nurse and fumigation of the room should be prac- 
ticed. The patient should not be allowed to mingle 
with other people for about a month after the dis- 
ease disappears. The second attack of Scarlet 
Fever is not common. 

FKVERISH CHILDREN. 

Children are very susceptible to influences which 
cause a rise of temperature in the body; and the 
fever frequently is not significant of any great 
danger. A perfectly well child may in a few hours 
flush up and the temperature run up two or three 
degrees. Sometimes a passing attack of indiges- 



120 CARE OF THE BODY IN HEALTH AND DISEASE. 

tion is the cause of it. Usually a mild purgative, 
and allowing the child to be kept at rest will in a 
day or so at least, bring about a cure. The child 
should be allowed all the water he wants; his head 
should be kept cool, and his feet kept warm. Noth- 
ing should be given to eat until the fever disappears ; 
and then a light diet for a day or two will be all 
that will be required. 

THE NURSING OF DIPHTHERIA. 

The nursing of Diphtheria patients requires 
that they be confined strictly to the bed. Even 
in cases that appear rather mild exertion some- 
times causes fatal results. There is a tendency 
in many cases, owing to the poison that is in the 
blood produced by the micro-organism, to paralysis 
of the heart. 

As to diet it. should be of liquids, and when the 
appetite is sufficient, reasonably nourishing in 
character. As a rule milk and animal broths are 
the best diets. If the case is a nursing infant it 
should not be put to the breast, but fed on the 
mother's milk after being obtained by the breast 
pump. The care of the breast pump demands 
scrupulous attention in the w^ay of cleanliness. 
It should lie in water to which has been added a 
lump of washing soda, and should be rinsed before 
using again. 

With the exception of the physician and nurse 
no one should be allowed in the sick room. Isola- 
tion should be complete, regarding both the sick 
room inmates and all objects with which they come 
in contact. All dishes and utensils used in the 
sick room should be boiled in water for 20 minutes. 



THE PROPER CARE OF YOUNG CHILDREN. 121 

All articles not strictly needed should be removed 
from the sick room; such as carpets, stuffed furni- 
ture and drapery. 

In administering treatment, to insure against 
danger, the nurse should hold a piece of glass or 
cloth before her face as the patient may cough 
and expel some of the poisonous matter, which is 
contagious, and might be conveyed to the nurse 
in this way. All cloths used in wiping away dis- 
charges should be burned at once. 

A disinfecting solution should be kept in the 
bed chamber, and after the discharges are discharged 
into the chamber, it should be allowed to stand a 
half hour or more. 

The nurse should go out into the open air each 
day, and should eat plenty of good digestible food. 
After recovery of the patient the room may be 
fumigated with formalin solution. 

During convalescence Diphtheria patients often 
manifest a tendency to paralysis. It may involve 
the eyes, certain muscles of the throat may be 
affected, so the patient swallows with difficulty, 
or the arms and legs may be to some extent paralyzed. 
With rest, and hygiene, the patient generally re- 
covers. Sometimes kidney disease is a sequel of 
Diphtheria. Any indications of this, such as 
scanty urine, should be reported to the physician. 
As little exertion as possible should be indulged 
in for weeks after recovery, as heart paralysis is 
said to be more likely to occur in convalescence 
than in the initial stage. 

THE NURSING OK TYPHOID FEVER. 

In nursing a case of typhoid fever the patient 



1 22 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

should be put to bed and kept as quiet as possible. 
All excitement or exertion causes loss of his ener- 
gies, which is certainly needed in tiding him through 
this severe fever. 

The nurse should impress upon the patient the 
necessity of giving up and confining himself to 
the bed. A mattress is most suitable for him to 
lie on. Feather beds are not suitable. A cotton 
mattress in the summer or wool mattress in the 
winter is the kind of bed for the patient. Every- 
thing should be done to keep down the body tem- 
perature. The room should not exceed 70 degrees. 
In warm weather sheets wrung from ice water are 
useful hung up in the room. By the cold water 
vaporizing brings down the temperature consid- 
erably. Ventilation is absolutely necessary; though 
a draught is not desirable. 

When the physician orders sponging or bathing 
for the reduction of temperature in typhoid, he 
should give specific directions as to the temperature 
of the bath. In sponging or bathing no undue 
pressure should be made on the patient's abdomen 
by the nurse, as the bowels are very tender and 
the abdomen swollen. 

The patient should not be allowed to lie too 
long on his back. In fact it is desirable to change 
the position reasonably often. This should be 
done with much gentleness and care. In the 
meantime the nurse should notice the prominent 
bony parts to see if bed sores are likely to form, 
and if they are the physician's attention should be 
called to it. 

The patient should have an abundance of pure 
water. Water flushes the system and assists ma- 






THE PROPER CARE OF YOUNG CHILDREN, 1 23 

terially in getting rid of the poisons. It might 
be regarded as part of the curative treatment. 
When the fever is high the ice cap should be em- 
ployed, or in the absence of this cloths wrung from 
cold water applied to the head. 

In regard to diet a fluid diet should be rigidly 
adhered to. I have found sweet milk often to 
disagree. Buttermilk partially sour is one of the 
best diets for a typhoid fever patient ; but if he has 
an appetite for broth he may be allowed chicken 
broth or other animal broths. 

Great care is necessary in the return to solid 
foods, after the patient is convalescing. Solid 
foods have been known to cause death weeks after 
the fever ended. One of the very particular times 
is when the appetite is beginning to return to the 
patient. His appetite has been perverted by the 
disease, and he often craves things that would 
prove fatal to him. The nurse should not allow 
kindness to overrule good judgment in the matter 
of feeding. There need be no fear that the patient 
will starve to death if he has plenty of the diets 
named above. Beef tea is often given and some 
would think it a food. It has very little nourish- 
ment in it; it is more of a stimulant than a food. 
The fluids taken by ' the patient especially milk, 
should be swallowed slowly; otherwise in the case 
of milk, curds often form and disagree with the 
patient. It is the duty of the nurse to examine 
the discharges carefully in the absence of the physi- 
cian, and report in detail as to their character. 
Regularity should be observed in giving medicines 
and foods; with the exception of when the patient 



124 CARE OF THE BODY IN HEALTH AND DISEASE. 

sleeps ; and then he should not be awakened to give 
either medicine or food. 

During the early morning hours the patient is 
usually very weak and should receive special atten- 
tion in regard to his diet. Some food in the early 
hours of the morning helps to tide him over the 
weakness. No special rules can be laid down as 
to the exact amount in each case. The condition 
of the patient and his ability to take it should 
serve as guides for its administration. Usually 
as much as he will take of the kinds stated above 
will not prove harmful to hirn. It is better to give 
small quantities at short intervals; say every two 
or three hours during the day, would suit in most 
cases, than to only feed him two or three times a 
day. In very low cases the patient should be kept 
absolutely in the recumbent posture so as to favor 
the weakened heart as much as possible. 

The feet should be carefully noticed by the nurse 
and always kept warm. This favors the heart 
When the physician allows the patient to sit up 
for the first time, the nurse should carefully attend 
to him, for often they become fainty, and should 
at once be placed down. 

With the proper care from the nurse the disease 
can generally be kept from spreading, by the proper 
disinfection and the disposal of the discharges. 
The chief danger of spreading is from the discharges 
of the bowels, as the disease is essentially a bowel 
disease. Their discharges are often swarming with 
micro-organisms that cause the disease. 

The bed chamber should always contain an 
antiseptic solution which should not be emptied 
under an hour after the patient makes use of the 



THE PROPER CARE OF YOUNG CHILDREN. 12 5 

chamber. After the nurse handles the chamber 
she should immediately bathe her hands in an 
antiseptic solution prepared for the purpose. Bad 
cases require bed clothing to be changed every 
day. The disease is oftener seen in persons from 
ten to forty years old than in any other age ; though 
children and old people sometimes have the disease. 
It is less dangerous in children than it is in adults. 
The surroundings and the water should be care- 
fully examined by the physician and such directions 
followed as he may direct. 

THE NURSING OE INEEUENZA OR EAGRIPPE. 

In the nursing of Influenza at the beginning of 
the disease a dose of a mild purgative may be given. 
A warm bath is also a good thing. It should be 
managed in such a way that the patient will not 
take cold. He should rest under covering after 
taking a warm bath, and some hot drink adminis- 
tered that will sweat the patient often relieves 
him greatly and appears to lessen the severity of 
the attack. When the attack is even mild it is 
best for the patient to rest in bed to prevent com- 
plications. 

If the patient has an appetite he may be allowed 
most any nourishing wholesome diet. Should his 
appetite be poor, milk and broth will be sufficient. 
In some cases there is a high fever with influenza. 
In such cases the ice cap should be had recourse 
to. Once a person has had this disease they ap- 
pearjto be very liable to it again. In prolonged 
attacks of this disease it is well for the patient to 
change rooms as he may reinfect himself if he is 



126 CARE OF THE BODY IN HEALTH AND DISEASE. 

not isolated. He can easily convey it to someone 
else, as the organisms are in the sputa. 

Pleasant surroundings and a cheerful nurse are 
very desirable in this disease for the patient often 
suffers from depressed spirits. After the attack 
is over the patient is often very much debilitated; 
for that reason he should be well nourished and 
rather slow to resume his occupation. 

To aid the skin in its eliminative function, bath- 
ing should be frequently resorted to. The disease 
goes lighter with children than with grown people, 
with the exception of very delicate young babies. 
In stout robust persons it might be regarded as 
nearly free from danger; but in old persons it is 
frequently fatal; usually assuming the type of a 
low fever with a bronchitis associated, and cold 
weather swells the mortality list among the aged; 
especially in the large cities, to a very considerable 
degree. 

THE NURSING OF PNEUMONIA. 

In Pneumonia the nurse should carefully observe 
the| expectorations of the patient in the absence 
of the physician, and report to the physician as to 
their character, for it is very important that this 
be done. 

Pneumonia patients are apt to perspire very 
freely. The nurse should take a dry soft towel 
and remove this perspiration often, as a great deal 
of impurities are reabsorbed if allowed to remain 
on the skin. The clothing should be changed 
often and the patient kept comfortably warm. 
The room should be well ventilated, for a stifling 
ill-ventilated room often does great harm in a 
disease of this nature, 



THE PROPER CARE Otf YOUNG CHILDREN. I27 

On no account should the feet be allowed to get 
cold, for cold feet has a great tendency to weaken 
the heart. The temperature of the room should 
range from 70 to 80 degrees. The room should 
not be allowed to be crowded with visitors. Talk- 
ing and every form of excitement is decidedly 
against the patient. In this disease the heart 
has a great extra work thrown on it; and anything 
that tends to weaken the heart is against the re- 
covery of the patient. In severe cases the head 
should not be raised for any purpose. 

In regard to the diet, milk and animal broths 
are the main dependence. 

This disease at the present day is regarded as 
infectious, and the germs of infection are in the 
sputa of the patient, and the safest plan would be 
to disinfect the sputa or cloths that are used to 
spit on should be burned before they get dry. When 
the sputa becomes- dry it is easily pulverized and 
often floats around as dust, laden with germs, and 
may be inhaled by others. 

The crisis or turning point of the disease is about 
from five to nine days, and this always takes place 
very abruptly. I saw a patient once with a tem- 
perature of 104 breathing at the rate of about 60 
times a minute, and exceedingly restless in the fore 
part of the night, and next morning at sun up the 
fever was all gone and the patient resting very 
easy, and the patient recovered. It had been a 
typical case of pneumonia. 

In healthy adults the disease is usually recovered 
from, except in cases where there is an unusual 
amount of lung involved. It is more dangerous 
in young children but in old age it is truly a fatal 



128 CARE OF THE BODY IN HEALTH AND DISEASE. 

disease; for in true pneumonia a man over sixty 
does not often get over it. 

THE NURSING OF SMAI^POX. 

In all cases of smallpox where it is possible, the 
patient or patients should be placed in a hospital 
of some description; but if the sufferer has to be 
cared for at home strict precaution should be taken. 
The patient should be isolated and have no visitors 
except a nurse. The poison exists in the secretions 
and the excretions of the patient, and is exhaled 
from the lungs and skin. It is also in the dried 
scales, and is scattered all over the room the patient 
stays in. It becomes attached to furniture, cloth- 
ing, etc. 

The patient should be strictly quarantined; 
should have a good comfortable airy room. When 
the fever runs very high it should be reduced by 
cold sponging. If the patient has much headache 
an ice cap may be applied. Ice-water and ice- 
lemonade are good drinks. The care of the eyes 
is very important. They should be bathed several 
times during the day with warm water. The erup- 
tions sometimes appear abundantly in the hair or 
on the scalp. To prevent matting, the hair should 
be cut short. 

Cleanliness should be rigidly enforced. In order • 
to prevent itching of the pustules on the face, the 
face may be anointed with glycerine or vaseline. 
If the patient has a good appetite the diet may 
consist of milk, eggs, animal broth and oysters. 

During convalescence the patient should be bathed 
once daily, and it is not safe for those that have 
not had the disease to be in contact with him until 



THE PROPER CARE OF YOUNG CHILDREN. 1 29 

the skin is perfectly clean and smooth. Varialoid 
or modified smallpox is the disease in one who has 
been vaccinated. It runs a very mild course, and 
very generally terminates in recovery, and seldom 
leaves any scars on the skin. It, however, is conta- 
gious and is subject to the same quarantine rules 
as unmodified smallpox. 



130 CARK OF THE BODY IN HEALTH AND DISEASE. 



CHAPTER IX. 

WHAT TO DO IN CASES OF POISONING. 

The first thing to do is to send for a physician. 
Often much may be done before the physician 
arrives. In all cases of poisoning it is of the utmost 
importance to get the poison out of the stomach 
before it enters the system. This can often be ac- 
complished by the administration of something 
that will cause immediate vomiting. 

As quickly as possible a teaspoonful of table 
salt and a teaspoonful of mustard should be dissolved 
in a half glass of water and poured down the pa- 
tient's throat, and repeated every fifteen minutes, 
until the stomach is thoroughly washed out. After 
this induce the patient to swallow the white of a 
raw egg, then a cup of strong coffee should be given. 
While each poison has special methods of treatment, 
immediately after the poison is taken, an emetic 
is highly useful before the poison enters the circu- 
lation. 

The after treatment of poisoning is highly im- 
portant, and when the physician arrives the case 
should be turned over to him. 

I will here give antidotes for some of the most 
common poisons. 

For all the acids, alkaline substances should be 
given. In the absence of anything else a solution 
of lime or even plaster will neutralize acids. Common 
soda or soap suds are alkalies, and will neutralize 
acids. Either one of which is most convenient 



AILMENTS AND REMEDIES. I3I 

may be used. After the alkalies are given freely 
in the case of acid poisons, the whites of raw eggs 
swallowed is highly useful to protect the stomach. 
In case the patient grows very weak, stimulants 
may be necessary. An ounce of whiskey or brandy 
for an adult may be allowed. 

Prussic acid or hydrocyanic acid is one of the 
most powerful poisons known. It kills so quickly 
in many instances, that there is no time for treat- 
ment. 

Peach nuts and bitter almonds contain prussic 
acid, and if eaten in sufficient quantity will produce 
symptoms of poisoning. In this case emetics or 
something to vomit the patient, as stated above, 
should be given speedily. Where the pure acid is 
taken there is rarely any time for emetics. Dash- 
ing cold water on the head, giving whiskey or brandy 
or by the injection of coffee into the bowels, or by 
inhaling of ammonia, comprise all the remedies 
that are likely to be of any avail. 

Aconite is a powerful poison. Merely tasting 
of some of the strong tinctures has caused death. 
The alkaloid obtained from it is an exceedingly 
powerful poison. 1-25 of a grain is regarded as a 
fatal dose. When either one of these poisons are 
taken into the stomach, the emetic of mustard and 
salt should be immediately administered and re- 
peated every fifteen minutes until the stomach is 
thoroughly washed out. The patient should remain 
lying down and not be allowed to get up for hours 
after the poison is taken. His feet should be kept 
warm ; brandy or whiskey should be given. 

In the case of poisoning by alkalies, acids should, 
be given in a diluted form. 



132 CARE OF THE BODY IN HEALTH AND DISEASE. 

Thus supposing a person to swallow potash or 
concentrated lye, vinegar will neutralize it. The 
vinegar should be diluted a little; about half water, 
and the patient allowed to drink say about a half 
glass. Lemon juice in the absence of vinegar will 
neutralize it. This should be followed by a dose 
of sweet oil or butter. 

Arsenic is a powerful poison. Two grains have 
proved fatal to an adult. Rough on rats and paris- 
green both contain arsenic. The salt and mustard 
emetic should be given at once. Then mix baking 
soda and tincture of chloride of iron together and 
give it freely. One tablespoonful will do no harm. 
Camphor in very large doses is poisonous. The 
salt and mustard emetic is to be given, followed by 
strong coffee. 

Corrosive sublimate is a powerful poison. The 
white of an egg should be immediately given for 
this poison, and then the salt and mustard emetic. 

Opium and its various preparations, such as 
laudanum, paregoric and morphine, are powerful 
poisons. The emetic of salt and mustard should 
be given, and repeated often until the patient vomits 
freely; then give plenty of strong coffee. A little 
whiskey is also good. The patient should be kept 
awake and cold applications applied to the head. 
Nothing should be done to exhaust the patient. 
Slapping and pulling and walking him around are 
all to his disadvantage. 

Phosphorus poisoning is sometimes met with in 
children who have eaten the heads of matches or 
tasted of insect destroyers, both of which contain 
phosphorus. The antidote is ordinary turpentine. 
The turpentine may be given in as many drops as 



AILMENTS AND REMEDIES. 133 

the patient is years old up to 20 years. It may be 
taken in barley water or gum arabic water. It 
may be taken every fifteen minute until four or five 
doses are given. Oils and fats must not be given. 
Sulphate of magnesia should then be given as a purge. 
Strychnine, sulphate of strychnine, and nux- 
vomica are all powerful poisons. One half a grain 
of strychnine has proved fatal to an adult. 

SYMPTOMS OF STRYCHNINE POISONING. 

The body is twisted in all directions, the teeth 
are clenched, and the patient has convulsions. 
The salt and mustard emetic should be given at 
once, and repeated every fifteen mintues until 
the patient vomits freely. 

DROWNING. 

In cases of drowning the patient should be laid 
across something, as a log, with his face and head 
downward to encourage the water to run out at 
the mouth. After the water has run out of the 
mouth it should be cleansed. To excite breathing 
the patient should lie on his side with his head 
supported. Should no success follow this proced- 
ure artificial respiration may be tried by Sylvester's 
method; then the extremities should be gently 
rubbed and warm applications applied. This treat- 
ment should be persisted in for some little time. 
Should it succeed the patient should be placed in a 
good warm bed and kept there until he fully re- 
covers. 

sun stroke. 

In sun stroke the face is red and the skin is hot, 
and the patient usually has a high fever. The 



134 CARE OF THE BODY IN HEAI/fH AND DISEASE. 

patient should be immediately removed to a cool 
shady place. The clothing should be loosened, 
and cold applications kept to the face comprises 
the treatment. 

HEAT EXHAUSTION. 

The face is pale and the skin cool, ^rhich is quite 
the opposite to sun stroke, and the treatment 
should be the opposite. The patient should be 
laid with his head low, and if he is able to swallow 
he may have a little drink of whiskey, and hot 
applications to his feet and a blanket spread over 
him comprises the treatment. 

NERVOUS PROSTRATION. 

This should be treated with a great deal of tact. 
The patient is usually crushed in spirits, and his 
will-power very much weakened. His nurse should 
encourage him and always be cheerful in his pres- 
ence. His food should be nourishing and easy of 
digestion. His appetite should be flattered. Fats 
being very essential to the nerve centers, butter 
should enter largely into the diet. 

HOW TO TREAT A WOUNDED ARTERY. 

The blood from a wounded artery spurts out in 
jets. The color is a bright red. Pressure should 
be made immediately between the heart and the 
seat of the wound. A knot may be tied in a hand- 
kerchief, the knot placed on the artery and the 
handkerchief tied around the limb as tight as it 
can be tied. The limb should be elevated. If 
the artery lies near a bone the flow of blood may be 
arrested by pressure of the finger against the wound, 
In case quite a small vessel or a number of small 



AILMENTS AND REMEDIES. 135 

vessels be wounded, hot water of 180 degrees may 
be applied by dipping cloths of gauze into the 
water and applying to the wound, until the physician 
arrives. 

HOW TO TREAT A CUT FINGER. 

The wound should be thoroughly cleansed and 
then dipped into very hot water. A soft cloth 
soaked in turpentine makes a good dressing. 

HOW TO TREAT A BLEEDING NOSE. 

The head may be wet with cold water at first. 
Should it not cease to bleed a little tampon of cotton 
rolled up until it is firm that can just be pressed up 
into the nostril should be applied ; and if it is pressed 
far enough back it will very generally succeed. 
In cases of protracted bleeding this tampon should 
be allowed to remain three or four days. 

BURNS. 

When burns are not sufficiently serious to require 
the services of a physician they may be dressed 
with olive oil or linseed oil, and a wet cloth should 
be applied. Burns caused by acids should be 
treated by the application of alkalies. Baking 
soda in solution is a good application. 

The danger of a burn is generally more according 
to the extent over the body than its depth. Just 
mere scorching the skin over half the body is very 
generally fatal. 

IN CASES OF CLOTHING ON FIRE. 

Carpets, rugs, or yarn blankets thrown around 
the patient will often smother the flames. 



I36 CARE OF THE BODY IN HEALTH AND DISEASE. 
IN CASE OF A FISH BONE IN THE THROAT. 

The patient may swallow a raw egg and the bone 
will frequently be dislodged. Should this fail a 
handkerchief wrapped around the finger may te 
passed into the throat and hang the bone and bring 
it out. 

IN CASES OF PERSONS STRANGLING. 

The swallowing of the white of an egg will gener- 
ally relieve him, unless the obstruction is in the 
windpipe. 

IN CASE OF A CHOKING CHILD. 

A good way to relieve it is to hold it by its heels 
and shake it, and the foreign body will fall out of 
its mouth. 

Should an insect get into the ear a little oil of 
any kind will drown it out. The ear should then 
be washed out with warm water. As the poison 
of the insect is usually acid, alkali will usually 
neutralize it. Common baking soda applied in a 
strong solution is a good application. 

IN CASES OF SNAKE BITES. 

Common table soda should be freely applied 
in a strong solution; or in the absence of this, lime 
may be wet and applied to it. 

In injuries of the eye, such as particles of dust, 
can often be removed by flushing of the eye with 
clean warm water. Where the injury is from an 
acid an alkali like common baking soda in strong 
solution should be applied. 

In cases of small foreign bodies lodging in the 
conjunctiva it often can be removed by gently 
rubbing a piece of raw cotton over the eyeball. 



AILMENTS AND REMEDIES. 1 37 

For removing sun tan, a very good application 
is equal parts of glycerine and lemon juice. 

To relieve tired inflamed feet, soak the feet in 
warm water and dry them, and then bathe them 
in alcohol. This toughens the skin of the feet and 
proves a very good remedy. 

To relieve ear ache pour as warm water as the 
patient can bear into the ear. Repeat this several 
times and wrap the ear up with dry flannel. 

In case of frost bites, immediately after the bite 
the parts should be rubbed with snow or ice water. 
Heat should not be applied at once. But for the 
annoying effects of the bite, hot water gives relief. 

For common colds the feet may be bathed in 
hot water, and for adults as much as ten grains of 
quinine may be given just before going to bed. 
This will usually sweat the patient and relieve him 
some. 

FOR CHRONIC RHEUMATISM OR RHEUMATIC PAINS. 

Where the patient does not suffer from loss of 
appetite nor indisposed enough to go to bed, the 
following is good treatment: 

The patient should wear flannel next to his skin, 
and warm clothing in damp and cold weather, and 
never allow himself to get wet, and should apply 
hot water to the parts affected, and keep his bowels 
free with simple purgatives. 

FOR PIEES OR HEMORRHOIDS. 

The patient should never allow his bowels to 
become constipated. He should bathe with a 



138 CARE OF THE BODY IN HEAI/fH AND DISEASE. 

solution of common soda and hot water, and then 
anoint with glycerine. 

A GOOD W T AY TO RELIEVE CONSTIPATION. 

Take an injection of olive oil every three or four 
days. A half pint injected very slowly into the 
bowels from a fountain syringe will often give 
considerable relief. The patient in taking this in- 
jection should lie upon his side and he should then 
turn after a few minutes on his back, and then on 
his other side, and then back on his back, and then 
on his other side. The reason for assuming these 
positions is that the oil may find its way around 
into the curvatures of the bowels. 

FOR PROLAPSED OR FALLING BOWEL. 

First bathe the parts in warm water, then anoint 
with olive oil, then dip a folded towel into warm 
water and exert gentle but persistent pressure upon 
the bowel and it will very generally succeed. 

In treating of ringworm, something should be 
used to kill the parasite, and this can generally be 
done with bichloride of mercury. Two or three 
grains should be dissolved in a half a pint of warm 
water; then with a soft rag dipped into this solution, 
bathe the ringworm. Three or four applications 
will generally succeed. 

FOR SHINGLES. 

The parts diseased should be painted with col- 
lodion. This relieves the pain by excluding the 
air and prevents the clothing from irritating the 
parts. 



AIIvMENTS AND REMEDIES. 139 

For the cure of corns on the feet, with a sharp 
knife pare off the hard part of the corn and apply 
a drop of nitric acid with a little glass rod or stick. 
This will usually cure the corn. 

TO PREPARE EPSOM SAIvTS SO THE STOMACH 
WIIvI, NOT REJECT THEM. 

Put a tablespoonful in a glass, then fill the glass 
half full of boiling water. After stirring well pour 
off the liquid and throw away the sediment. Now 
add a little lemon juice and allow the mixture to 
cool. Now fill the glass with cold water. The 
dose can now be taken. 



140 CARE OF THE BODY IN HEALTH AND DISEASE. 



CHAPTER X. 

PREPARATION OF FOOD AND DRINK. 

As the preparation of foods and drink for sick 
people is very important I will here quote the 
preparation of a number of them that will be found 
very useful in nursing. The quotation is made 
from a hand book on nursing prepared by S. Vir- 
ginia Levis M. S. N. 

"Barley Water — Add one tablespoonful of pearl 
barley to one and a half pints of water; boil down 
to one pint and strain through muslin. Add salt, 
sugar or lemon juice; or if desired to increase its 
nutrition, employ the whites of two eggs. 

Rice Water — Follow directions for making bar- 
ley water. 

Plain Whey — Heat a half pint of milk luke warm 
and add one teaspoonful of the essence of pepsin; 
beat with a fo r k until the curd is finely divided, 
then strain. 

Albumenized Water — Into a quart jar place one 
cup of cold water, the white of one egg, one table- 
spoonful of lemon juice and one tablespoonful of 
sugar; blend them thoroughly by shaking. 

Albumenized Milk — Place the white of one egg 
and one half pint of milk in a qua r t jar and shake 
them together. 

Lemon Whey — Bring half a pint of milk to the 
boiling point; remove from the fire and add juice 
of a half a lemon; stir once or twice and strain; 
add two teaspoonfuls of sugar. 



PREPARATION OF FOOD AND DRINK. 141 

Tamarind Whey — Stir one tablespoonful of tam- 
arinds into a half a pint of milk while boiling; strain 
and sweeten to taste. 

Orange Whey — Proceed as for lemon whey, sub- 
stituting the juice of one or two sour oranges with 
a piece of the peel. 

Wine Whey — Bring a half pint of milk to the 
boiling point and pour into it four tablespoonfuls 
of sherry wine; stir once or twice and when the 
curd separates remove from the fire and strain, 
sweetened with one teaspoonful of sugar. 

Egg Nog — Beat thoroughly the yolk of one egg 
with one tablespoonful of sugar, then stir these 
with well beaten white; now add either one pint of 
milk and one tablespoonful of sherry wine, or one 
tablespoonful each of ice water, milk and wine. 

Plain Junket — Heat a half pint of milk merely 
luke warm; sweeten and add one teaspoonful of 
the essence of pepsin. Stir only enough to mix 
thoroughly and pour into cups. Let these remain 
in a warm place until set; then place on ice. 

Cream Junket — Proceed as for plain junket, 
substituting cream for milk. A little tart jelly 
may be placed on top. 

Egg Junket — Shake together in a jar one egg 
with a scant half pint of milk; one or two teaspoon - 
fuls of sugar and a little salt. Turn into a sauce 
pan and heat until hike w 7 arm, stirring constantly; 
then proceed as for plain junket. Flavor with 
vanilla or other extracts. 

Coffee Junket — Mix if pints of milk, one-half 
pint of strong coffee, and a half a cup of sugar; 
heat until luke warm and finish as a plain junket. 
The top may be heaped with whipped cream. 



142 CARE OF THE BODY IN HEAI/fH AND DISEASE. 

Chocolate Junket — Heat one quart of milk luke 
warm; add a half cup of sugar and stir until dis- 
solved. Melt two squares of chocolate in a half 
a cup of the warm milk, and boil a moment; care- 
fully add to it the remainder of the milk with one 
teaspoonful of vanilla. Finish as in plain junket 
It may be served with sweetened cream. 

Wine Jv.nket — Add two tablespoonfuls of sugar 
to one pint of milk, which must be heated nearly 
luke warm; add one tablespoonful or more of sherry 
wine, with a little nutmeg, and proceed as for plain 
junket. 

Mulled Wine — Place a clove and a little piece of 
cinnamon in a half cup of boiling water, and con- 
tinue to boil a few minutes. Take out the spices 
and add four or five tablespoonfuls of port wine; 
allowing the mixture to reach the boiling point, 
pour this over one well beaten egg and sweeten 
to taste. 

Wine Posset — Boil two or three slices of bread 
in one pint of milk; when soft remove it from the 
fire adding nutmeg and two teaspoonfuls of sugar. 
Pour this slowly into six or seven tablespoonfuls 
of Madeira or other wine. 

Wine Jelly — Soak one box of gelatine in one 
half pint of cold water for two hours ; then pour in 
one and a half pints of boiling water, stirring well. 
Add the juice of one lemon, one pound of sugar 
and one pint of sherry wine; strain and turn into 
cups or molds. When cold place on ice. 

Grape Jam — Wash the grapes and take out the 
pulps; place the pulp and skins in separate vessels 
and cook until tender. Put through a colander 
to get rid of the seed. To each pint of pulp allow 



PREPARATION OF FOOD AND DRINK. 143 

one pound of granulated sugar; allow another 
pound for each pint of skins; the juice must be 
pressed well from the skins ; put pulp juice and sugar 
together and boil until thick; add the skins and boil 
two minutes; remove from the fire and empty into 
sealed jars. 

To Sterilize Milk — Place the milk in a glass 
vessel having a wide mouth, covering the opening 
with a piece of absorbent cotton or cheese cloth; 
place it upon the stove in a pan containing cold 
water and remove the moment the water reaches 
the boiling point ; cool it rapidly. An x\rnold steam 
sterilizer is excellent for this and similar purposes. 

Kumiss — Dissolve in one third of a cake of com- 
pressed yeast one tablespoonful of warm water, 
or substitute other yeast; add one tablespoonful 
of sugar to one quart of fresh milk and heat until 
blood warm ; stir in the yeast and empty into tightly 
corked bottles ; stand the bottles upright in a warm 
place over night where the thermometer registers 
70 or 72 degrees; then place them on their sides in 
an ice box ; this will keep good and sweet for almost 
three days. 

Peptonized Milk — Regular Process. Place one 
tube of peptonizing powder in a quart preserving 
jar along with a half pint of cold water; shake well 
and add one pint of cold milk; heat some water 
hike warm and standing the jar in the bath allow 
it to remain fifteen minutes. Unless correctly 
prepared milk will acquire a bitter taste. 

Peptonized Milk — Cold Process. Place one tube 
of peptonizing powder with a half a pint of water 
in a quart jar; shake together and add one pint of 
cold milk; place at once on ice, 



144 CARE OF THE BODY IN HEALTH AND DISEASE. 

Peptonized Milk — Quick Process. Proceed the 
same as for the cold process, but instead of placing 
at once upon ice turn it into a sauce pan and allow 
it to come to the boiling point. 

Peptonized Milk — Special Process. Into a quart 
jar place the contents of one peptonizing tube with 
one half pint of cold water; after shaking well add 
one half pint of cold milk; heat some water luke 
warm and allow the jar to remain in this water 
bath for one hour, placing the bath where it will 
keep luke warm ; then pour it into a sauce pan and 
bring it to the boiling point in order to stop for the 
peptonizing; milk so treated can be used for lemon- 
ade and punches as it will not curdle. 

Milk Lemonade — In a goblet put a little crushed 
ice and the juice of a lemon; sweeten to taste and 
fill the goblet with cold milk which has been pep- 
tonized by the special process. 

Punches — Add an equal part of mineral water 
to cold milk which has been peptonized by the 
special process, or to one glass of the special pep- 
tonized milk add one tablespoonful of brandy or 
other liquor. 

Lemonade Flip — Beat together three teaspoon- 
fuls of sifted sugar and one fresh egg; add the juice 
of one lemon to three fourths of a glass of water; 
then add this to the sugar and egg y beating all the 
while. 

Modified Cream — To a half a glass of fresh cow's 
cream add an equal quantity of pure water and 
sweeten to taste. 

Arrow Root-Mix one teaspoonful of Bermuda 
Arrow Root with a little milk and stir this into a 
half pint of boiling milk; sweeten to taste and add 



PREPARATION OF FOOD AND DRINK/ 145 

a pinch of salt ; flavor with nutmeg or one teaspoon- 
ful of brandy. 

Arrow Root Pudding — To one quart of boiling 
milk and three and one half tablespoonfuls of arrow 
root, which has been dissolved in a little cold milk, 
add one cup of sugar and in a few minutes take 
from the fire; into this stir four beaten egg> and a 
little nutmeg and cinnamon or other flavoring; 
pour into a w^ell buttered ves»e! and bake Fo» a ^ialf 
an hour in a quick oven; a few minutes before tak- 
ing from the oven sift two tablespoonfuls of sugar 
over it and set it back to glaze. 

Farina Gruel — Moisten one tablespoonful of fa- 
rina w r ith a little cold water; stir this into a cup of 
boiling water and let it cook for ten minutes; then 
add one cup of milk, a pinch of salt, and one or 
two teaspoonfuls of sugar and let it boil one minute 
longer. 

Milk Toast — Place a large slice of stale bread 
in the oven to dry. Toast it evenly and moisten 
it with a little boiling water; pour over it about a 
cupful of boiling milk thickened with flour, and to 
which has been added a small piece of butter and a 
pinch of salt. 

Graham Cream Toast — Toast one or tw r o slices 
of Graham Bread; bring about one cupful of rich 
cream to the boiling point. Add a pinch of salt 
and pour over the bread which has previously been 
buttered. 

Gluten Bread — To one pint of scalded milk add a 
teaspoonful of salt, and when luke warm add half a 
yeast cake, or substitute other yeast; dissolve the 
compressed yeast in about two tablespoonfuls of 
warm water; stir in about one pint of gluten flour 



146 CARE OF THE BODY IN HEALTH AND DISEASE. 

and the beaten white of one egg. To make the 
batter sufficiently thick it may be necessary to 
add -more flour. After beating well turn into a 
greased pan; cover it and stand it in a warm place 
to raise; when about double its bulk, bake for one 
hour or longer in a moderate oven. 

Oatmeal Gruel — Soak for five minutes one table- 
spoonful of rolled oats in three tablespoonfuls of 
cold water; add one and one half pints of scalding 
water and boil for half an hour ; it may be strained 
or not, after which add a half pint of milk, return 
to the fire and bring to the boiling point; add a 
pinch of salt after removing from the fire and sweeten 
or not, as desired; nutmeg may be added. 

Cracker Gruel — Moisten two tablespoonfuls of 
cracker crumbs with a little cold milk; stir this into 
a kind of boiling milk and cook five minutes, stirring 
constantly; then add a pinch of salt; also a little 
cinnamon if desired. 

Rebecca's Food — Place in a bowl several soda 
crackers over which has been shaken a pinch of 
salt, sugar and cinnamon to taste; pour over them 
two or three times as much boiling water as would 
be required to cover them to allow for swelling. 

Soft Boiled Eggs — Carefully drop the eggs into 
boiling water and immediately remove the vessel 
from the fire and allow the eggs to remain in the 
water for four or five minutes. 

Egg Omelet — Beat together the yolks of two eggs 
and four tablespoonfuls of milk; add a pinch of 
salt to the whites and beat them very stiff; mix 
all together and turn into a hot well greased sauce 
pan; brown quickly and fold over once. 

Eggs on Toast — Put some water on to boil in a 



PREPARATION OF FOOD AND DRINK. 147 

shallow sauce pan and place a slice of stale bread 
into the oven to dry; break an egg into the boiling 
water, and while it cooks toast the bread; butter 
the toast, sprinkle salt over it and lay it on a plate; 
when the egg is merely cooked through, place it on 
the toast, and moisten the toast with a little of the 
boiling water in which the egg has been cooked. 

Soft Custard — Put a half a pint of milk on the 
stove to scald; beat one egg } yolk and white to- 
gether, add to it one and a half tablespoonfuls of 
sugar and a pinch of salt; pour slowly into this 
mixture the scalded milk, stirring constantly; 
return to the fire and cook for two or three minutes ; 
then flavor with wine or some flavoring extract. 

Egg Custard — Break the yolk of one egg into a 
cup and add to it one or two teaspoonfuls of sugar; 
add a pinch of salt to the white and beat it well; 
then add this to the yolk and sugar; fill the cup 
with milk, stir well and bake until the top is brown; 
nutmeg or any flavoring may be added if desired. 

Com Starch Pudding — Dissolve one and a half 
tablespoonfuls of corn starch in a little milk; add 
two well beaten eggs, one and a half or two table- 
spoonfuls of sugar and a pinch of salt; gradually 
add the mixture to one pint of milk which has been 
brought to the boiling point, and boil about four 
minutes, stirring briskly; remove from the fire 
and add in the desired flavoring. 

Corn Starch Blancmange — Dissolve two table 
spoonfuls of corn starch in a little milk and add 
two tablespoonfuls of sugar and a little salt; stir 
the mixture into one pint of boiling milk and cook 
four minutes ; remove from the fire and flavor with 
lemon, nutmeg or whatever is preferred. 



148 CARE OF THE BODY IN HEAI/fH AND DISEASE. 

Tapioca Pudding — Soak one tablespoonful of pearl 
or flaked tapioca for two hours in a cup of cold 
water; cook until clear, then add a half pint of milk 
and the yolk of one egg beaten with a half a cup 
of sugar and cook for about ten minutes until thick; 
remove from the fire and stir in the well beaten 
white of the egg, adding nutmeg or vanilla. 

Fruit Sauce — Mash one pint of strawberries or 
other fruit to a pulp; stir in a half a cupful of gran- 
ulated sugar, and let the mixture stand for an hour 
and a half or longer; then stand the dish and con- 
tents in a pan of boiling water and let it come 
nearly to the boiling point. This may be served 
with blancmange, boiled rice or almost any pudding. 

Rice Pudding — Into quart pudding dish put a 
half a cupful of well washed rice; one and a half 
pints of milk, nearly one cup of sugar, a large pinch 
of salt, and nutmeg or other flavoring; bake in a 
moderate oven for two hours, stirring at intervals 
during the first hour; to be eaten cold, with or 
without cream. 

Rice Meringue — Cook four tablespoonfuls of rice 
until very soft ; add a small piece of melted butter, 
a half a pint of milk, the yolks of two or three eggs, 
a little salt, and lemon juice or other flavoring; pour 
into cups a little more than half full; set them into 
a pan of boiling water and bake fifteen minutes; 
beat the. white of the eggs with sifted sugar; place 
on top of the custards and place back in the oven 
to brown slightly. 

Sago Pudding — Put two tablespoonfuls of pearl 
sago in one cup of cold water to soak over night 
add one pint of milk and set on the stove to scald ; 
add the beaten yolkes of two eggs and two thirds of 



PREPARATION OF FOOD AND DRINK. 149 

a cup of sugar and boil a few minutes; take from 
the fire and add a pinch of salt and vanilla or other 
flavoring; then pour slowly over the stiffly beaten 
whites of the eggs. 

Orange Sago — Soak one cup of sago in three 
cups of water over night; add one or two table- 
spoonfuls of sugar and cook until clear. While 
hot pour this over three or four sliced oranges 
and set away to cool. 

Irene's Pudding — Bring a half a pint of milk to 
the boiling point and thicken it slightly with corn 
starch or flour, then add one tablespoonful of 
sugar, a well beaten egg } a piece of butter and 
salt to taste; remove from the fire and flavor with 
vanilla; while hot pour this over small pieces of 
sponge cake or slice peaches; when cool set on ice. 

Farina Custard — Moisten two tablespoonfuls of 
farina with a little cold milk; add to one pint of 
boiling milk and cook five minutes; stir in two 
well beaten eggs, three tablespoonfuls of sugar, 
and a little salt, and cook a minute longer. Re- 
move from the fire and add any desired flavoring. 
w. Hasty Pudding— -Mix until smooth, one table- 
spoonful of flour, a pinch of salt and a little milk; 
add this carefully to one scant pint of boiling milk ; 
stirring constantly; remove from the fire when 
thick. It may be eaten hot with sugar or butter. 

Baked Tapioca Pudding — Soak two tablespoon- 
fuls of tapioca in a half a pint of cold water over 
night and cook until soft; when coo! add one quart 
of milk, three or four well beaten eggs, one cup of 
sugar, some salt and flavoring; bake about three 
fourths of an hour. 

Raisin Custard— Add a small handful of seedless 



150 CARE OF THE BODY IN HEALTH AND DISEASE. 

raisins to one pint of milk and cook gently for about 
twenty minutes; dissolve one teaspoonful of corn 
starch in a little cold milk; add this with two tea- 
spoonfuls of sugar and a pinch of salt, to the hot 
milk; cook two minutes longer. 

Bread Pudding — To one quart of cold milk add 
six or seven tablespoonfuls of sugar, a little salt, 
and four or five well beaten eggs; also a few slices 
of stale bread cut into small squares and buttered ; 
bake until firmly set and the bread is brown on top ; 
test with a knife blade. If desired a thick layer 
of slightly mashed and well sugared strawberries 
may be placed on top, and the pudding returned 
to the oven for a few minutes longer. 

Apple Whip — Cook two apples until soft, drain 
and pass through a colander; sweeten to taste, 
add the whites of one or two beaten eggs, whipping 
together until smooth. 

Fruit Foam — Beat the white of an egg to a stiff 
froth and add two teaspoonfuls of powdered sugar 
and one tablespoonful of fruit juice; briskly beat 
all together. 

Fruit Fluff — Beat the yolks of five eggs with a 
cup of sugar and add a half a pint of mashed straw- 
berries or other fruit, together with the juice of a 
lemon; cook merely long enough to thicken, then stir 
in the stiffly beaten whites; put into tumblers and 
set on ice. 

Clam Broth — Take a half a dozen unopened clams ; 
thoroughly scrub the shells and drop into sufficient 
boiling water to cover them; cook until the shell is 
open and strain the liquor. A dash of red or 
black pepper, or three or four drops of the tincture 



PREPARATION OF FOOD AND DRINK. 151 

of capsicum may be added to each cupful of the 
broth. 

Clam Soup — For obtaining the liquor, follow 
the directions as given under the heading of Clam 
Broth; season to taste, and add an equal quantity 
of scalded cream or milk, with crackers and nutmeg 
if desired; boil a few minutes. 

Sweetbreads — Soak for one hour in cold water 
and parboil for fifteen minutes in salted water; 
place them again in cold water for a few minutes 
and remove the skin; place on ice until ready to 
cook. Cut them half lengthwise and broil. 

Cream Oysters — Mix one tablespoonful of flour 
with a little cold milk and stir into one pint of 
boiling cream; allow one pint of oysters to come 
to a boil in their own liquor; reject the liquor, turn 
the oysters into the cream, and season to taste. 

Oysters on Toast — Cook a half a dozen oysters 
in their own liquor until they swell and are heated 
through. If they are cooked longer than is neces- 
sary they will be tough. Toast a slice of stale 
bread; butter it, moisten it with juice, and lay the 
oysters on top. 

Oyster Soup — Scald a pint of milk then add the 
oyster juice and bring to a boil. Season to taste 
and add the oysters, removing the soup from the 
fire when the edges of the oysters begin to curl. 

Potato Soup — Into one pint of milk and a half 
a cup of water place two small potatoes cut into 
slices or small cubes ; also a stalk of celery cut fine ; 
one half tablespoonful of butter, and a half a chopped 
onion if desired. Boil a half an hour and season 
to taste. 

Invalid Soup — Soak one tablespoonful of pearl 



152 CARE OF THE BODY IN HEALTH AND DISEASE. 

sago in one cup of cold water for ten minutes and 
cook until perfectly tender and well thickened; 
bring a half a pint of milk or a fourth a cup of 
cream to a boiling point and add to it one well 
beaten egg; now add the sago and one pint of hot 
beef tea, mixing all well together. 

Tomato Soup — Mash two or three large ripe to- 
matoes and press through a fine sieve to get rid of 
the skin and seeds ; to the express juice add a little 
water to allow for evaporation and boil for fifteen 
minutes ; then add half the quantity of milk slightly 
thickened with flour, a piece of butter, and season- 
ing to taste, and bring to a boil. 

Beef Juice — Slightly but quickly broil a piece 
of juicy steak; cut it into convenient squares and 
place in a lemon squeezer; express the juice into a 
warm cup and season it to the taste ; or flavor with 
a little wine, whiskey, brandy, or vanilla, and 
freeze. 

Beef Tea — Take one pound of beef, reject all 
the fat and cut it into very fine pieces; soak it in 
one pint of cold water for two hours; heat it very 
gradually; then allow it to gently simmer for about 
ten minutes; do not boil it; season to taste and 
strain. 

Mutton Broth — Wash one pound of lean mutton; 
place it in one pint of cold water with a little salt 
and one tablespoonful of pearl barley or rice; boil 
gently for two hours and skim. 

Chicken Broth — Cut up the fowl and soak it for 
one hour in salt and water; boil it gently until the 
meat shrinks from the bones; take out the chicken 
and salt the broth; add rice or barley and continue 
cooking until tender; stir one cupful of hot milk into 



PREPARATION OF FOOD AND DRINK. 1 53 

two beaten eggs and add this to the broth and bring 
to the boiling point and strain. 

Cocoa — When too much cocoa is used it will 
impart a bitter taste; a half a teaspoonful of the 
powder will usually be sufficient for one cup. It 
is not necessary to previously mix the powder with 
cold water; simply sprinkle it on top of the milk 
after it has been set on the stove. When the milk 
is luke warm stir it in. Cocoa will not thoroughly 
dissolve in a cold medium, and will lump in a hot 
liquid. Boiling for two or three minutes will im- 
prove the flavor. It is more nutritious when made 
of all milk, 'though a little water might be added 
to allow for evaporation. 

Flax Seed Tea — Pour one pint of boiling water 
over one ounce of whole flax seed and a little pul- 
verized liquorice root; let this set on the cool part 
of the stove for about four hours, then strain and 
place it on ice. Lemon juice may be substituted 
for the liquorice. 

Fruit Juice as a Drink — Fill a glass two thirds 
full of cold water sweetened to taste and add the 
juice of currants or other fruits in whatever quan- 
tity desired; a little jelly may be substituted for 
the juice. 

Apple Water — Wash and core one large apple, 
retaining the peel; slice it into a sauce pan and pour 
over it one pint of boiling water. Keep it covered 
and cook gently for about twenty minutes; strain 
and add sugar to the taste; nutmeg may be added 
if liked. 

Orangeade — Pour a cup of boiling water over the 
rind of one sour orange; add two teaspoonfuls of 



i54 care o^ ThE body in health and disease. 

sugar, and when cool add the juice and strain and 
set on ice. 

Pine Apple Water — Peel one large pineapple, 
then slice it and pound it to a pulp; pour over it 
one pint of boiling syrup, add the juice of a lemon 
and an orange, stir well and let it set for two hours, 
then strain and add one quart of pure cold water. ' 



DRUGS MOST COMMONLY USED BY THE PUBLIC. 1 55 



CHAPTER XI. 

DRUGS MOST COMMONLY USED BY THE PUBLIC. 

From time immemorial medicines and drugs 
have been made use of by the general public. Ages 
ago they used decoctions and infusions — or in other 
words they boiled their herbs, bark and roots, and 
it would appear that even physicians had no way, 
or at least used no process to have any definite 
strengths for the medicines they used. Their closes 
were consequently indefinite, and in case of poison- 
ous medicines it was not at all unlikely that harm 
often resulted; and at the present day the people 
make use of a great many official medicines with- 
out knowing the proper dose. It would probably 
be the best if all the drugging business or the ad- 
ministration of medicines was turned over to the 
physician; but that is not the case, for all classes 
of men are more or less given to prescribe for them- 
selves at times. Many of them use proprietary 
and patented medicines. Of these I know very 
little, but of the official medicines, that are official 
in the pharmacopiea, that are used by the public, 
I have some knowledge. As the people will use 
them I think it best they should be enlightened as 
to their nature, the effects and dosage. 

HYDRARGYRI CHLORIDUM MITE. 

Mild chloride of mercury commonly called cal- 
omel is prepared from mercury and chloride of 
sodium or common salt. 



156 CARE OF THE BODY IN HEALTH AND DISEASE. 

It is a dull white, heavy powder, permanent in 
the air, odorless, with little or no taste. It is inso- 
luble in alcohol and water. 

The authorized dose for an adult is from one-half to 
ten grains. In children it is often given in too small 
doses though little children can often take much 
larger doses than are generally used, with advantage. 
A child a year old can bear a grain of calomel very 
well, and one two years old can bear two grains; 
and it usually takes that amount at least; to give 
them an ordinary purge. These doses last referred 
to can be increased about a half a grain to the year 
of the age of the child. It is proper to give it on 
a fasting stomach. It is not a very dangerous drug 
except it be continued for a number of doses. It 
should be given on a fasting stomach and allowed 
to work off before the patient eats. 

In the case of adults from eight to ten grains is a 
fair dose for a purgative effect. 

It was once thought to be a drug capable of 
breaking fevers, but investigations have shown 
that it is not capable of breaking any continued 
fever. Under the impression that it would arrest 
the progress of fevers physicians of past generations 
often used it in small doses at short intervals, for 
days and weeks, with the result of salivation and 
sometimes loss of the teeth, and a weakening of 
the constitution. When used in this way it impairs 
the constitution by dissolving the red corpuscles 
of the blood and weakening the patient generally. 

One of the main uses of calomel is its stimulation 
to the secretions, and its cleansing effect en the 
stomach and bowels ; and in suitable cases it hardly 
has any equal in this regard, A main important 



DRUGS MOST COMMONLY USED BY THE PUBLIC. 157 

point is that it should be taken in doses sufficient 
to produce a full purgative effect or be followed 
by epscm salts eight or ten hours later. It has 
an antiseptic action that makes it highly useful 
in the diarrheas of children, and I am satisfied I 
have seen several children saved by good sized 
doses of calomel that had suffered for months from 
this disease. It is not a drug to be taken contin- 
uously, but in certain cases it may be repeated two 
or three or four times ; taking care that it be given 
in sufficient quantity to take good effect; and it is 
often very well to flush the bowels out after taking 
of it, with sulphate of magnesia. 

Calomel has the power of lowering the temperature 
in a number of severe diseases of a febrile nature. 
This undoubtedly is due to its eliminating poisons 
from the system, that causes the elevation of tem- 
perature ; and in this way given occasionally, proves 
useful, especially in the first stages of typhoid fever, 
pneumonia, billious remittent fever, simple contin- 
ued fever, intermittent fever, pernicious remitttent 
fever, and yellow fever, and many other diseases. 
In common billiousness, inactivity of the bowels, 
foul stomach, and inactivity of the liver, a dose of 
calomel that acts freely is often highly useful. 

Children bear the drug mighty well, and in diar- 
rhea, cholera infantum, or constipation of little 
infants, a full dose of calomel often proves of the 
utmost advantage, 

To get the beneficial effects of it the prescriber 
should see that it is fully worked off. It is not a 
very certain drug in its action, and should it not 
take effect in eight or ten hours the dose should be 
repeated, or sulphate of magnesia should be given 



158 CARE OF THE BODY IN HEALTH AND DISEASE. 

so that it should be eliminated from the system 
and secure its beneficial action. In adults it can 
often be combined with vegetable purgatives with 
a decided advantage. Three or four grains of 
aloes combined with eight or ten grains of calomel 
produces one of the most desirable cleansing purges 
in many instances, that can be produced by any 
drug. One drawback to calomel is that it is apt 
to make some people sick when they take it; and 
most persons in taking a large dose are more or 
less nauseated. 

Intelligence and discretion should always be 
exercised in the use of this drug as in the use of 
any other drug; for when a drug is not positively 
indicated it not infrequently does harm by disturb- 
ing of the secretions. In most acute diseases a 
good calomel purge taken without food is not to 
be condemned. 

Calomel acts upon the kidneys; and in cases of 
inactivity of those organs, or even in dropsy it 
sometimes proves highly useful; especially if the 
dropsy be of renal origin. Some persons are more 
readily affected by calomel than others. A single 
dose will slightly salivate some people, but not to a 
harmful extent. 

I might here give some of the symptoms of sal- 
ivation so anyone using it may guard against it. 

Its first symptoms are sore teeth; often more 
or less slight looseness; spongy gums, an unusual 
flow of saliva, a fetid disagreeable breath, a bluish 
line along the margins of the teeth, then swellings 
of the glands about the jaws. As it advances the 
jaws and muscles ache, and the patient fevers up 
and emaciates; he often loses his appetite; he looks 



DRUGS MOST COMMONLY USKD BY THE PUBLIC. 1 59 

pale, and his hair will fall out often; sores will form 
about the mouth; a diarrhea will supervene; the 
patient becomes nervous and trembling, and in 
women abortion; the teeth may fall out, and even 
destruction of the lips and part of the jaws. These 
last named symptoms are very severe, and are never 
produced by one or two doses of the drug. 

In the first stages of Syphilis, calomel given in 
three or four grain doses once or twice a week is 
highly useful. 

Calomel is incompatible with the chief part of 
the materia medica. With aloes, rheubarb, and 
podophillin it goes very well. It should not be 
given with the acids nor iodide of potassium. 

POTASSII IODIDUM. 

(or Iodide of Potassium) 
This drug is prepared by dissolving resublimed 
iodine in a solution of caustic potash, and by evap- 
oration with charcoal. As it is generally sold, it 
is in the form of cubical crystals, or a coarse white 
powder, It is very soluble in water. It has a dis- 
agreeable, strong saltish taste, and is a highly 
useful medicine. It is used a great deal by the 
people as well as by the physician. It is not a 
dangerous drug except when given in very large 
doses. In some persons it will cause loss of appe- 
tite, and in that case should be suspended from 
time to time and if it be necessary to continue the 
use of the drug, resumed again. 

The authorized dose of the drug is from five to 

sixty grains. The best time to use it is after meals, 

largely diluted with water. It is a drug that may 

be used for weeks, months or even years where 



l6o CARE OF THE BODY IN H^AI/TH AND DISEASE. 

strictly indicated, without harm. To lessen its 
disagreeable taste when the patient is taking large 
doses of it, it may be dissolved in water and an 
equal amount of syrup of hydriodic acid added to 
it, which has the same effect, and makes it much 
more agreeable to take; for in taking large doses 
the patient often gets very much against it. It 
is an exceedingly powerful drug in the management 
of syphilis, and it is not surpassed by any drug in 
its curative power of scrofula. It is also useful in 
chronic phthisis or tuberculosis of the lungs when 
that disease is of a chronic nature. Where the 
patient is not fevered up and quite a moderate 
amount of the lung involved, and the patient's 
appetite is good, it is one of the most useful drugs 
in this last named disease, that we possess. Of 
patients suffering from acute tuberculosis or fevered 
up, a large amount of the lungs involved, or bed- 
ridden, it is of little or no use. In many cases of 
chronic rheumatism by improving the functions 
of the glands, it is often highly useful. 

It should be taken for weeks or even months, and 
in case of a relapse of the disease it should be had 
recourse to again. In some cases of Asthma it 
has a beneficial effect, and in some cases of Bron- 
chitis it is highly useful. 

In Conjunctivitis, Iritis, or other inflammation 
about the eyes produced by a scrofulous state of 
the system, it will do more good than any other 
drug with which I am acquainted. I here refer 
to scrofula, as that is the old name of it; but there 
can be no doubt that scrofula is a form of tubercu- 
losis; not differing from tuberculosis of the lungs 
other than the tissues involved. 



DRUGS MOST COMMON IvY USED BY THE PUBLIC. l6l 

In taking Iodide of Potassium the patient may 
eat plenty of good nourishing food and drink freely 
of water; and if his appetite is poor he may take 
bitters to improve his appetite. This drug is in- 
compatible with nearly every other drug in the 
materia medica except those of iodine. As before 
stated, it may be given with syrup of hydriodic 
acid, which has the same effect, or iodide of sodium, 
or iodide of ammonium, all of which have similar 
effects to iodide of potassium. 

There are some little drawbacks to Iodide of 
Potassium. I have mentioned the effect on the 
appetite. It sometimes produces a little eruption, 
a sneezing, pains about the jaws, and a running 
at the nose. 

In children of one and two years old, the dose- 
should be about two grains three times a day, 
taken after meals, largely diluted with water; and 
one grain may be added to the dose for every year 
of the child's age until he becomes an adult. 

CINCHONA OR PERUVIAN BARK. 

There are several varieties of these barks. They 
all yield Quinine, The tree is a native of South 
America. There can be about twenty one alka- 
loids obtained from them; but there are only four 
of much value. Quinine, Quinidine, Cinchonine, 
and Cinchonidine. The preparation from this tree 
most commonly used is a salt from the alkaloid 
sulphate quinine prepared by the action of sul- 
phuric acid on the quinine, and is called sulphate 
of quinine; the people also call it quinine. It is 
used extensively by the people as well as the phys- 
ician. 



1 62 CARE OF THE BODY IN HEAI/fH AND DISEASE. 
OUININAK SULPHAS. 

(Or Quinine Sulphate.) 

The authorized dose of this drug by the profes- 
sion is from one to twenty grains. In small 
children it may be giv^n in from one half to two 
grains. It is not a dangerous drug, 'though if used 
in large doses it has a depressing effect upon the 
nervous system. It is largely used in the treatment 
of Malaria; especially of the intermittent type, 
and is the nearest an antidote we have. It should 
be given in large doses in intermittent fever. Usu- 
ally three times a day is often enough to give it. 
It is very useful in billious remittant fever, 
though it will not arrest the fever at once. It 
may be given in moderate doses throughout the 
disease. It has the power of lowering the temper- 
ature in fevers generally, but as far as my experi- 
ence has gone it is utterly useless in typhoid fever. 

In influenza or Lagrippe, after a simple purge 
it is a very excellent remedy. In pernicious remit- 
tent fever it is our sole dependence. As a prophy- 
lactic against malaria, it is regarded as highly use- 
ful in all the malarial districts. Many persons 
use it when well to keep from having the disease 
in the low swampy Southern parts of the United 
States. It is largely used to break up colds. It 
is very doubtful whether it has this power or not, 
'though it has a considerable power to give relief, 
and in this way benefits the patient. 

Quinine is a good antiseptic. It has a good 
effect in Septicemia. It gives a good deal of relief 
in neuralgia. It is also useful in hay asthma or 
hay fever. 



DRUGS MOST COMMONLY USED BY THE PUBLIC. 1 63 

Some of the drawbacks to its use after the effects 
have passed off, large doses of the drug leave a 
loss of vision, but tbis is very generally temporary ; 
the sight being restored soon after the quinine is 
left off. 

Although quinine is not dangerous drug, it is 
used more than is necessary by the public. 

sulphur. 

Sulphur is an elementary body, and one of the 
few that is used in its elementary form as a medi- 
cine. A dose is from ten to sixty grains for an 
adult. Children under five years old can take a 
grain for each year of their age. It seems to be a 
remedy that has been used for ages, and not near 
so much as formerly ; 'though there can be no doubt 
that it possesses some good medicinal properties. 

It is a mild laxative when taken into the system. 
It is easily defused through the tissues, and will 
stain silver coins carried in the pocket. 

Some of the diseases that it has been used in are 
chronic rheumatism. It no doubt benefits some 
cases. In scabies or itch, Sulphur applied locally 
kills the parasite. It should be mixed with some 
kind of an ointment ; as lard or some oily substance ; 
or in the form of sodium sulphite, 30 grains to the 
ounce of water used as a bath is very efficient in 
curing Scabies. 

In acid indigestion sometimes Sulphur proves 
curative. 

In gangrenous wounds, sulphurous acid is a highly 
useful application. The pure acid should be di- 
luted with 10 yolums of water. In lead poisoning 



164 CARE OF THE BODY IN HEALTH AND DISEASE. 

as seen sometimes in painters, sulphur baths are 
regarded as highly useful to eliminate the lead. 

Although Sulphur has very few drawbacks when 
it is taken, it is best administered alone. 

OPIUM. 

Opium is the inspissated juice obtained from the 
poppy, or papaver somniferum, grown in Asia 
Minor. The natives tap the unripe capsules, or 
incise them. They are generally tapped just before 
sundown. The juice that exudes becomes inspis- 
sated by evaporation, and is scraped off of the 
shrubs and made into lumps. 

The characteristics of these irregular lumps is 
that they weigh from two or three ounces to two 
pounds enveloped in the remains of poppy leaves. 
When broken or torn they tear in an irregular way. 
They are of a chestnut brown color. The surface 
is shiny when rubbed, having a peculiar odor and 
a bitter taste. Pure Opium should yield about ten 
per cent, of morphine. Powdered Opium is dried 
at a temperature of about 185 degrees fahrenheit, 
and reduced to a fine powder. Opium is a very 
complex substance. It has a number of vegetable 
principles in it, with 17 or 18 alkaloids. Morphine 
is the most important of the alkaloids. The salts 
of morphine are hydroclorate of morphine; acetate 
of morphine, and sulphate of morphine. The last 
named is the one in most general use. 

The dose of powdered Opium is from one to tw r o 
grains. Opium is a poison. Five grains is consid- 
ered a fatal dose for an adult. 

Opium and all the alkaloids act chiefly on the 
nervous system, When Opium is taken in small 



DRUGS MOST COMMONLY US^D BY THE PUBLIC. 1 65 

doses one fourth to one grain. At first there is a 
stage of excitement of the circulation. The pulse 
are a little fuller and quicker. The skin is usually 
warm and flushed. During this stage the individual 
has a power of directing his attention to any par- 
ticular object, and the action of the drug causes 
him to do well whatever he wishes to do. Should 
he wish to sleep, and circumstances are favorable, 
usually a quiet sleep comes on. Usually after a 
few hours the effects pass off leaving him with a 
slight headache and languor, with dryness of the 
mouth and slight nausea. If on the other hand 
he wishes to work he can do this with increased 
energy. If he desires to exert the mind, his imag- 
ination is more vivid, and his power of expression 
is greater. 

With moderate doses, one or two grains, the 
stage of excitement is short, and the sleep for the 
most part is deep ; yet the patient can still be aroused 
The after effects are severe headache with nausea, 
furred tongue and loss of appetite. During this 
state of sleep the brain is anemic. It is said that 
the veins and arteries are nearly empty in brain 
during the sleep produced by opium. When the 
doses are large; say three grains or more; the first 
stage is very short, and sleep rapidly follows and 
becomes deeper and deeper, and if the person be 
not used to opium, coma develops from which the 
patient can no longer be aroused. The face is 
generally pale with a bluish tinge, as a rule; the 
eyes are sunken, the pupils are very much con- 
tracted; almost to the size of a pin's point. The 
breathing is slow and of a snoring character; the 
pulse is now slow and full. If coma proceeds it 



1 66 CARE OF THE BODY IN HEALTH AND DISEASE. 

becomes feebler, and finally death occurs, the res- 
piration ceasing before the heart ceases to beat. 
Before death the patient may have convulsions, 
but this is not common. 

In children the poisonous effects of opium are 
more readily produced than in adults. Children 
under one year of age often bear it exceedingly 
bad. One minim has produced fatal results. 

Again in old age, smaller doses should be given, 
as old people bear the drug badly. Women are 
more readily affected than men. Some persons 
are more easily affected by it than others. In 
some persons, instead of being put to sleep by it, 
it produces excitement and hinders them from 
sleeping altogether. 

The effects of habit in the use of this drug is quite 
strange. After persons have used it for a great 
while they can take what would be a fatal dose to 
an ordinary adult, without being much affected 
by it; not even put to sleep by it. 

Persons have useri a dozen grains a day of mor- 
phine, hypodermically without producing a fatal 
effect. This quantity would kill several that had 
never used the drug. 

The first effect of opium is to stimulate, and 
afterwards to depress. Persons that become opium 
eaters, when the after effects come on, they want 
another dose of the drug, and in this way the habit 
becomes firmly established. After persons have 
used opium for a long time, or any of its alkaloids, 
so the habit is confirmed, the mental powers be- 
comes enfeebled; the moral faculties perverted, 
and it is said that they are unable to distinguish 
between truth and falsehood. It also effects the 



DRUGS MOST COMMONLY USED BY THE PUBLIC. 1 67 

motor system; the gait becomes shuffling and un- 
certain, and the digestion is impaired. 

Some persons cannot take opiates without un- 
pleasant effect. In a number of persons it excites 
vomiting, which will not yield to any remedy. 
This vomiting can only be checked by withholding 
opium altogether, or any of its preparations. 

Opium has been used from very ancient times. 
It appears from the literature on the subject that 
it was in use long before the beginning of the Christ- 
ian era. It appears to have been a popular drug 
all down through the ages, and at the present day 
is used extensively. Truly enough, it relieves 
pain and produces sleep, but upon the whole I do 
not look upon it as a very valuable drug. There 
are many other ways to relieve pain, and opium 
and its preparations have many unpleasant effects. 
Occasionally a dose of opium can be given without 
harm, but as a routine measure, it is doubtful if 
it is ever indicated. 

Morphine, Laudanum, Paregoric, and Apomor- 
phine and Codeine, are all obtained from opium, 
and partake more or less of the characters and 
effects of that drug. Morphine is used very ex- 
tensively in form of a sulphate. The dose is from 
one sixth to one third of a grain. It is used hypo- 
dermically a great deal. People often learn to 
use it themselves and make regular use of it in 
this way. 

As the public use this drug extensively in some 
form or other I might say that it should not be 
used by the public at all. It is more than likely 
that it has caused more deaths than any other 
drug we possess. Its professional use is not always 



l68 CARE OF THE BODY IN HEALTH AND DISEASE- 

judicious, and many persons are more easily af- 
fected by it than others, and persons suffering from 
severe diseases bear the effects of it badly. In 
short — it produces some of the symptoms that is 
peculiar to many severe diseases. One very noted 
one is locking up of the secretions. 

When one has the headache, better than to 
take a dose of morphine he would do much better 
to take something to clear his stomach; or if his 
little baby has the belly-ache he would better take 
a fountain syringe and some warm water and wash 
out the child's bowels than to give it an opiate. 
If he cannot sleep at night he would often be more 
benefited to take a hot bath before he goes to bed 
than a dose of opium. 

When one gets in a habit of using opium to pro- 
duce sleep he has to increase the dose or it will 
produce no effect as a rule; and should he use the 
drug a great while he will frequently get so that 
he cannot sleep without it, inasmuch, it disturbs 
his digestion and locks up his secretions, and he is 
constantly having to resort to purgatives, and often 
it will disturb his appetite, and he will have to 
resort to bitters to improve his appetite, and when 
he quits the opium he is generally in a worse condi- 
tion than he was when he began it. 

In speaking of opium of course all the other 
preparations that is derived from it is included 
with it. 

I failed to mention the doses of Laudanum and 
Paregoric. The authorized dose of Laudanum is 
from ten to twenty drops, of Paregoric one to two 
drachms. A drachm of pure laudanum is regarded 
as a fatal^dose, but pure laudanum is very much 



DRUGS MOST COMMONLY USED BY THE PUBLIC. 1 69 

stronger than it is generally found put up in little 
bottles. I am unable to go into any details as to 
the evil effects of opiates more than what has al- 
ready been stated, but enough has been said to 
imply that the public should never use any opium 
in any of its forms. 

Nearly all the soothing syrups and cordials pre- 
pared for children, contain opium in some form; 
and as they often prove harmful the people should 
not use them in any form whatever. 

NUX VOMICA. 

Nux Vomica is obtained from the seed of strych- 
nos nux vomica, a shrub of East India. The seeds 
are nearly circular in form ; about an inch in diame- 
ter; umbilicated and slightly convex on one side; 
of an ash grey color; thickly covered with short 
satiny hairs; translucent internally; tough and 
horny, and exceedingly bitter, and without oder. 

Nux Vomica has two alkaloids, strychnine and 
brucine. The brucine is not much used in medicine, 
and is not important to be described in this place. 
The seeds of Nux Vomica are sometimes powdered 
and used as a drug. The authorized dose is two- 
fifths of a grain. 

The beans of St. Ignatius also contains strych- 
nine. The activity of the Nux Vomica seeds de- 
pends entirely upon the strychnine and brucine 
they contain. vStrychnine occurs in square octahe- 
drons or prisms. They are rather small in size, 
and are colorless crystals, and have no smell. 
Strychnine is sparingly soluble in water, although 
it communicates its intensely bitter taste. It 
dissolves readily in boiling alcohol and in chloro- 
form, but is not soluble in ether. 



170 CARE OF THE BODY IN HEALTH AND DISEASE. 

Strychnine is generally used in the form ot a 
salt, which is sulphate of strychnine. The author- 
ized dose is from one-sixtieth to one-twentieth of a 
grain. 

Taken in small doses strychnine improves the 
appetite and increases the activity of the intestines 
and therefore lessens the tendency to constipation. 
When taken in small doses for a long time the drug 
produces increased sensibility of the sensory nerves 
so that impressions are felt more acutely. The 
sense of the touch is said to be rendered more acute ; 
the field of vision is increased, and distant objects 
are seen more distinctly. The sense of hearing 
is also sharpened. Taken in larger doses it increases 
sensibility more decidedly, and it also increases 
sexual desire. If the drug still be pushed further 
it produces anxiety, restlessness, twitchings of the 
muscles, stiffness of the neck, and convulsions. 
These symptoms may be produced, varying in 
different individuals, from about one-sixteenth of a 
grain to one-fifth of a grain. 

When a dose of a half a grain of strychnine has 
been taken, symptoms of true poisoning set in, in a 
period varying from five minutes to five hours. 
They are ushered in without vomiting or any other 
warning. The first symptom is general convul- 
sions; the teeth are clenched; the pupils are dilated, 
the patient often resting on his head and heels 
with the hands clenched and the arms drawn 
tightly toward the body. The spasm only lasts 
about a minute and is followed by a period of re- 
laxation. The slightest stimulus, as a draught of 
cold air, is sufficient to bring on another attack. 

Death results either from asphyxia, which occurs 



DRUGS MOST COMMONLY USED BY THE PUBUC. 171 

during spasms, or from paralysis and collapse, 
which comes on during the period of relaxation. 

The treatment of strychnine poisoning consists 
in evacuating the stomach before the convulsions 
begin; but if this cannot be done, chloroform or 
ether should be given, and the stomach washed 
out while the patient is under the influence of the 
anesthetic. 

SOME OF THE USES OF STRYCHNINE. 

Strychnine is a good tonic in dyspepsia by stimu- 
lating the nervous system; it strengthens digestion 
and assimilation; it also increases the movements 
of the stomach, and gives tone to the vessels of 
that organ. As a tonic it is very useful during 
convalescence from acute diseases. In dyspepsia 
due to indigestible articles of diet or to alcoholic 
stimulants, it is useful. It is also useful in sick 
headache by strengthening digestion. 

It strengthens the action of the heart, and in 
very weak hearts many practitioners prefer it to 
alcoholic beverages. It is regarded as useful as a 
respiratory stimulant; it causes the patient to 
breathe deeper, and is probably useful in failure 
of respiration. 

In depression due to mental overwork it is re- 
garded as a valuable remedy, as it increases the 
mental powers ; but strychnine is a drug that should 
not be given for a very long period at a time. It 
is said that it has a tendency to accumulate in the 
system. 

It was once thought to be useful in paralysis, 
but in paralysis from any organic disease it is most 
likely worthless. 



172 CARE OF THE BODY IN HEALTH AND DISEASE. 

It is serviceable in sexual debility. Its action 
in this direction sometimes proves an inconveni- 
ence in its administration for other effects; but as 
it is a powerful poison, and the people at large are 
not well acquainted with its effects, it should never 
be used by the public except as prescribed by a 
physician. 

GENTIANAE RADIX, 

(Or Gention Root.) 

This root is obtained from the mountainous 
districts of Central and South Europe. The root 
is from a half to one inch in thickness, and several 
inches long; often twisted and much wrinkled or 
marked with close transverse rings. Its color is 
brown externally, and yellow within. The taste 
is at first sweet and afterwards very bitter. 

It is generally used in the form of a fluid extract 
or a compound tincture. The dose of the fluid 
extract is from ten drops to a half a teaspoonful, 
and the dose of the compound tincture is from 
one drachm to a half an ounce. 

Gention taken before meals is a v^ery excellent 
appetizer ; and as it is not a dangerous drug it may 
be used by the public. It is also useful in dyspep- 
sia as it tends to strengthen digestion. 

JAIvAPA, 

(Or Jalap.) 

Jalap is the dried root of a shrub of Mexico 
The root varies from the size of a nut to that of an 
orange. It somewhat resembles an egg in shape. 
It presents in color a yellowish grey color, with 
dark brown circles. It is used in the form of com- 



DRUGS MOST COMMONLY USED BY THE PUBLIC. 1 73 

pound Jalap powder, the dose of which is from 
20 to 60 grains. 

Resin of Jalap from two to five grains is the dose , 
and fluid extract of Jalap, the dose of which is 
from ten drops to a half a teaspoonful. 

Jalap is a very active purgative. It is useful 
in some forms of dropsy; especially that due to 
renal disease. It is useful in some forms of consti- 
pation, associated with congestion of the brain. 

A very convenient way of taking of it is in the 
form of compound Jalap powder, as the bile dis- 
solves it ; and it appears that this is required before 
it will act, for it has no action when it is injected 
into the veins or under the skin. 

Jalap is not a dangerous drug, and may be used 
by the public without harm. 

DIGITALIS FOLIA, 

(Or Digitalis leaves.) 

This drug is sometimes called Foxglove, and 
as people sometimes make use of it without it being 
prescribed by a physician, I will describe it. 

It is collected from the wild plants when about 
two thirds of the flowers are expanded. This 
drug contains several principles that act very differ- 
ently, one from the other. The extract of Digitalis 
is used in doses of about one fourth of a grain. 
The fluid extract is used in doses from one to two 
drops, and the infusion of Digitalis is used in doses 
of about from one to two fluid drachms, and the 
tincture of Digitalis is used in doses from five to 
ten minims, and Digitalin is an active principle 
obtained from Digitalis, the dose of which is fr )m 
one sixtieth to one thirtieth of a grain. 



174 CARE OF THE BODY IN HEALTH AND DISEASE 

These are the chief preparations of the drug 
that is used in medicine. 

By chemical analysis there are at least five prin- 
ciples that exist in Digitalis, which all have differ- 
ent actions. In large doses Digitalis causes sick- 
ness, vomiting, muscular weakness, and disturb- 
ance of vision, and embarrassed respiration and 
death; the heart usually failing before the respira- 
tion. 

The brain is unaffected in cases of poisoning, 
the mind remaining clear to the last. The respira- 
tion is generally somewhat slow, and occasionally 
before death it may become excessively slow. The 
effects produced on the circulation by the active 
principles of Digitalis are divided into four stages: 
First a rise of blood pressure, generally accompanied 
by a slowing of the pulse; second, a continued rise 
of blood pressure with a quick pulse, and third, a 
continued high pressure with irregularity of the 
heart's action; fourth, a rapid fall of the blood 
pressure, and sudden stoppage of the heart. 

By some authors the rise in blood pressure is 
regarded as owing to increased action of the heart, 
and not to the contractions of the vessels. With 
others however, the rise of blood pressure is re- 
garded as owing to contraction of the vessels. Slow 
pulse in the first stage of Digitalis poisoning is ow- 
ing to stimulation of the pneumogastic nerve partly, 
and partly due to increased sensibility or actual 
stimulation of the ends of the nerves in the heart. 
The irregularities in the third stage depends on 
the action of the heart itself. 

Small doses of Digitalis have a pleasant bitter 
taste, but it seems to exert no good effect on the 



DRUGS MOST COMMONLY USED BY THE PUBLIC. 1 75 

digestive organs. Larger doses produce loss of 
appetite, nausea and vomiting, and sometimes 
diarrhea. All observers agree regarding the action 
of Digitalis on the kidneys when the patient is 
suffering from valvular heart disease. 

The chief effects of Digitalis are a reduction in 
the rate of pulse and increase in the amount of 
urine when administered in therapeutic doses. 
The diuretic action is less when the heart is much 
affected. The preparation generally employed to 
act on the heart is the tincture, while the infusion 
is the best diuretic. 

Some of the chief uses of Digitalis are to tone 
the action of the heart when its action is irregular 
and feeble; and in dropsy it is useful in valvular 
disease of the heart, but when the arteries are dis- 
eased with a hypertrophy of the heart, it is not 
only injurious but dangerous. 

Digitalis is of use in sleeplessness, accompanied 
by drowsiness during the day, for these symptoms 
usually accompany a want of tone in the vessels. 

It was once used in fevers and in pneumonia it 
was thought to be a very useful drug, but it is now 
discarded as being of little or no use. 

The administration should always be stopped 
when Digitalis produces sickness at the stomach 
or fainty feelings, or disturbance of vision. A 
person in taking Digitalis, without the dose be very- 
small, should remain in bed. 

It will be seen from what has been said that 
Digitalis should never be used by the public only 
when prescribed by a physician. 



176 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

ALCOHOL. 

Alcohol used as a medicine — that is in medicinal 
doses, when taken into the stomach it causes in- 
creased vascularity and increased secretion accom- 
panied by a feeling of warmth; and it generally 
excites an appetite, for which purpose it is taken 
by some persons before meals. In cases of diar- 
rhea it has a somewhat astringent action. There 
is considerable disagreement respecting the nature 
of alcohol. Some regard it as a food and others 
not. The chief argument in favor of its not being 
a food is that it is eliminated in the urine unchanged , 
but this seems only to occur when it is given in 
considerable quantities. In small doses it is partly 
eliminated by the breath; but undoubtedly part 
of it undergoes combustion in the body. In this 
respect it agrees with some other foods; such for 
instance as sugar. The argument in favor of alco- 
hol being a food is that it is retained in the body 
and supplies the place of other foods so that the 
quantity of food which would be insufficient, with 
its aid becomes sufficient. 

After the absorbtion of alcohol into the circula- 
tion it dilates the vessels of the surface of the body 
and increases the rapidity of the pulse. From 
the freer circulation which thus takes place in the 
capilaries of the surface, the skin of the face and 
hands become more flushed. The blood flows so 
freely from the arteries into the veins that there 
is no longer time for it to become completely venous 
in its passage. In consequence of the capilaries 
being dilated the skin is no longer mottled, but of a 
uniformly pink color. The veins are distended* 



DRUGS MOST COMMONLY USED BY THE PUBLIC. 1 77 

they fill more rapidly when emptied, and are of a 
lighter blue than usual owing to the blood they 
contain being more arterial. 

The action of alcohol upon the temperature of 
the body is to lower it; still the person feels warmer 
after taking alcohol, and it is a noted fact that 
men under the influence of alcohol will freeze to 
death much more quickly than men that are not 
under its influence. 

The dangerous effects of alcohol in very cold 
countries is known to those who are exposed to 
the extreme cold weather. The arctic voyagers 
generally avoid its use altogether. Its action upon 
the nervous tissues seems to be one of paralysis, 
affecting them in the inverse order of their devel- 
opment, the highest centers being affected first 
and the lowest last. Thus the power of judgment 
usually goes first; while the imagination may be 
lively and the emotions even more than usually 
active. 

As a stimulant alcohol is servicable in shock, 
and in diseases running a very limited course, and 
to relieve pain, and in debilitated conditions of the 
system. It is sometimes useful in the loss of appe- 
tite and indigestion. In these instances it should 
be given just before meals; but in continued fevers, 
as typhoid, while in some cases it may be necessary 
at some stage of the disease, as a routine remedy 
it is likely it is never indicated. The tendency of 
most enlightened physicians is to use less and less 
alcohol in the treatment of disease. 

The term alcohol here is intended to embrace 
all the preparations that are drunk that have any 
per cent, of alcohol in them. Whiskey and brandy 



178 CARE OF THE BODY IN HEALTH AND DISEASE. 

usually have from 40 to 50 per cent, alcohol, and the 
dcse varies from a tablespoonful to one ounce. 

Champagne has about fifteen per cent, alcohol; 
wine has from five to ten per cent, usually, and 
beer from two to five per cent, alcohol. 

While the alcoholic preparations are admitted 
as very good medicines they should never be used 
in any other way only as a drug, 

AEOES. 

There are several species of Aloes. The soco- 
trine Alloes are the best. 

Character of Aloes — It is found in hard, redish 
brown, or yellowish brown masses. It has a 
bitter taste, and when breathed on has a saffron 
like odor. It dissolves entirely in proof spirits. 

The chief preparations of Aloes in use are the 
tincture of Aloes and the Wine of Aloes, and the 
Lump Aloes, and the active principle of Aloes which 
is Aloin. The dose of the tincture is from ten to 
thirty drops; and the dose of the wine of Aloes 
from ten to twenty drops. The dose of the lump 
Aloes is from one to six grains, and the dose of the 
active principle, Aloin, is from one-half to two 
grains. 

The Effects of Aloes. — Aloes in small doses has 
a tonic action like simple bitters. It increases 
peristalsis of the intestines, and also intestinal 
secretion. Its action is particularly exerted on 
the large intestines. This is shown by the great 
length of time from its administration until its 
action. It increases the secretion of bile by stim- 
ulating the liver. It only acts when mixed with 



DRUGS MOST COMMONLY USED BY THE PUBLIC. I 79 

bile and in consequence is useless in Jaundice where 
the bile does not enter the intestines. 

Aloes has little o r no purgative action when 
injected into the bowels, but is active if mixed with 
Ox bile. In acute and chronic poisoning by Aloes 
it exerts considerable influence on the urinary 
tubules. It also produces albuminuria. Aloes dif- 
fets from other purgatives in not causing constipa- 
tion after its use; but on the contrary it renders 
the intestine more sensitive so that the dose can 
gradually be reduced. As it does not cause con- 
stipation it makes it a very desirable purgative. 
As it acts very slowly in most persons it is not suit- 
able for cases requiring immediate action. It is a 
drug if used in small doses. It can be used for 
years without harm, and upon the whole it is one 
of the best vegetable purgatives there is. It is 
put up in pills and can be taken in that way, or 
the powdered aloes or lump aloes may be wrapped 
in any confection and taken. 

It is highly useful in stimulating the activity 
of the liver, and as it is not a dangerous drug in 
moderate doses, it is a very suitable purgative for 
the public to make use of. 

OLEUM RICINI, 

(Or Castor Oil.) 

The action of Castor Oil is that of a purgative 
and the dose for an adult is from a tablespoonful 
to an ounce; for children, one and tw r o years old, 
a teaspoonfui might be regarded as a dose, to be 
repeated every three or four hours until t takes 
effect. 



l8o CARE OF THE BODY IN HEALTH AND DISEASE. 

It is a very useful purgative in children, pregnant 
women, and persons who have piles, and delicate 
people generally. 

One of its chief objections is its disagreeable taste, 
but it can be flavored with a few drops of the 
mints; either peppermint or spheremint. Of late 
years it is highly prized in dysentry, and there 
are some forms of neuralgia can be cured by it if 
it be taken for several days in succession. 

In lead colics it acts as a preventive to consti- 
pation, and is also used as a curative agent. As 
it is not a dangerous drug it is a very suitable 
drug for the people to use. 

ROCHEEEE SAi/r. 

This occurs in colorless, transparent prisms, 
of exceedingly small size, and is generally eight 
sided. Its authorized dose as a purgative is from 
one-fourth to one-half ounce. 

It is one of the most useful mild purgatives we 
have. It is also a good diuretic. It may be used 
in congestion of the kidneys, in Brights Disease, 
and is also very useful in little children as a purga- 
tive when no other purgative will be retained on 
the stomach. In very large doses it is useful in 
dropsy; whether of renal origin or valvular disease 
of the heart; and as it is not a dangerous drug it 
may be used by the public. 

sodii suephas, 
(Or Sodium Sulphate.) 
The dose is from one-half to one ounce. Sul- 
phate of Sodium, when introduced into the stomach, 
excites peristaltic movement in it, and also has a 



DRUGS MOST COMMONLY USED BY THE PUBLIC. l8l 

similar action of the bowels. It produces in the 
intestines a secretion of watery fluid and acts as a 
purgative. It is used either alone or mixed with 
bicarbonate of Sodium, in ulcer of the stomach, 
chronic gastritis, and dilatation of the stomach. 
A good time to administer it is on rising early 
in the morning. A third of a teaspoonful taken 
largely diluted with water will frequently act on 
the bowels; but with a smaller quantity of water 
it usually will not act. Taken in this way early 
of a morning, it is often useful in chronic constipation 
and sluggishness of the bowels. As it is not a 
dangerous drug it may be used by the public. 

MAGNESII SULPHAS, 

(Or Sulphate of Magnesium; Commonly Called 
Epsom Salts.) 

It occurs in minute, colorless, transparent crys- 
tals that look very nearly like sulphate of zinc. 
Its taste is bitter. This distinguishes it from 
sulphate of zinc, which has a strong metallic taste. 
It readily dissolves in water. As a purgative the 
dose is from an ounce to an ounce and one-half; 
and in cases of dropsy this dose may be repeated 
every hour until six or eight ounces are taken; 
beginning early in the morning and used until 
noon, an ounce every hour on a fasting stomach. 
This will often eliminate large quantities of water 
from the system and give considerable relief in 
dropsy. Whether the dropsy be owing to the 
heart or the kidneys or the liver or general anemia. 

The best way to use it in dropsy is to take some 
active purgative that will produce a cleansing 
effect the night prior to its use. It also acts upon 



1 82 CARE OF THE BODY IN HEALTH AND' DISEASE. 

the kidneys, and is useful when there is a scanty 
flow of urine. As it is not a dangerous drug it 
may be used by the public. 

PODOPHIUvUM, 

(Or May Apple.) 

This grows in a bundance in some parts of the 
United States. It occurs in pieces of variable 
lengths, about one-fifth of an inch thick, of a dark 
redish brown color, and breaks with a short fracture 

The powdered drug and the tincture are most 
commonly used. Of the pow r der the dose is from 
one to three grains and the tincture from fifteen 
to thirty drops. It is used in cases of biliousness 
associated with dark discharges. It is useful in 
congestion of the liver and of the portal circulation 
in ague w T ith congested liver, and in sick headache 
and biliousness. Its action is rather uncertain 
and it often causes griping. When incautiously 
handled it may get into the eyes and produce con- 
junctivitis. In small doses it is not a dangerous 
drug, and therefore may be used by the public. 

OLEUM MORRHUAE, 

(Or Cod Liver Oil.) 
It is of a pale yellow color with a slight fishy 
odor and a fishy taste. It is used in doses of from 
a teaspoonful to one ounce. It might be regarded 
rather as a food than as a medicine, 'though it has 
traces of iodine in it, but not in sufficient quantity 
to be of any use. It has been largely used in Scrof- 
ula and in Tuberculosis, and Anemia, and in other 
diseases. It is very readily assimilated and makes 
a very good food, but is of little use as a medicine, 



NATURE AND ART IN THE CURE OF DISEASE. I 83 



CHAPTER XII 

NATURE AND ART IN THE CURE OF DISEASE. 

From very remote antiquity the power of nature 
in healing disease has been known to those versed 
in the nature of disease. Some of the most marked 
examples of the marvelous powers of nature to 
affect a cure are seen in acute pneumonia and ty- 
phoid fever; also in all the eruptive fevers. The 
intrinsic tendency is to get well without the use 
of any medicine under good nursing. It is certain 
that in those diseases medicines will not abort nor 
cut them short. 

In cases of disease of this nature all that medicine 
can effect is to assist nature in eliminating the poi- 
sons which produce death, and alleviating severe 
symptoms ; and in many other diseases the tendency 
is to get well. Even in tuberculosis where the 
treatment has been indifferent there are often scar 
formations, and where the deposits is in tubercu- 
lous lungs, nature often throws a wall around them 
and hems the organisms in. 

When the surgeon makes an incision into the 
cavity of the abdomen after he closes the wound 
in a few weeks he can open along the same line 
and find the tissues completely healed and the 
blood vessels rejoined again. This is evidently 
done by nature. In fact, when the cause of dis- 
ease is removed the tendency of nature is always 
to heal; and since we have been enlightened in the 



184 CARE OF THE BODY IN HEALTH AND DISEASE. 

nature of infectious diseases, the power of nature 
to heal are very much mqre apparent than ever. 
In many of the infectious diseases the organisms 
that cause the disease have a life history in the 
system; and in a period of nearly a definite dura- 
tion they die out; and if nature can be assisted 
until this takes place, recovery is almost certain. 
This however, does not set aside the value of a 
number of important drugs. Often in the process 
of disease the secretions are locked up; and one 
of the most important duties of the physician is 
to keep the secretions up and promote elimination; 
for a patient will live a great while suffering from a 
disease, if the poisons are not allowed to accumu- 
late in sufficient quantity to be a lethal dose. 

To make what has been said more forcible I will 
quote a passage from Austin Flint's Practice of 
Medicine. Dr. Austin Flint was one among the 
most scholarly and conservative physicians the 
United States ever produced, and did great honor 
to American Medicine. In his practice he says: 
"The history of medicine shows many and great 
mutations in the prevailing doctrines of Thera- 
peutics at different periods. The medical practice 
of the present day in many respects, is in striking 
contrast to that current a half century ago; and it 
is by no means improbable that a comparison with 
the present day at the end of the next half century 
will reveal points of contrast not less striking. 
These mutations, so far from being a reproach, 
illustrate the progressive character of medicine. 
Therapeutical principles can never become unchang- 
ably fixed until the utmost limits of obtainable 
pathological knowledge are reached, and nothing 



NATURE AND ART IN THE CURE OF DISEASE. I 85 

further remains to be ascertained by experience. 
It would be absurd to claim for medicine this per- 
fectability; but continued improvement in the 
management of disease may be reasonably ex- 
pected. The future improvement will doubtless 
embrace the addition of new remedies and meas- 
ures of treatment. More extended and precise 
knowledge of those already in use, and the correc- 
tion of errors, which probably now, as heretofore, 
renders sometimes, the efforts of the physician not 
only inadequate but prejudicial. The uniformity 
of the laws of disease at different periods and places, 
has been already referred to. The bearing of this 
on the stability of therapeutics is obvious. So 
also with reference to the same application, it is 
important to assume that the system of man is not 
liable to alterations, which render the operation of 
therapeutical agencies widely different at periods 
not far removed from each other. The opinion 
held by some that such alterations have occurred 
within the memory of those now living does not 
rest on any solid basis. Admitting to the fullest 
extent diversities attributable to race, climate, 
occupation, and hereditary influences, these do 
not invalidate the statement that the human con- 
stitution remains essentially unchanged, as regards 
the application of established therapeutical princi- 
ples. Were the truth otherwise it would strike at 
the root of medical experience. If changes requir- 
ing a revolution in therapeutics were liable to occur 
with each successive generation, it is evident there 
could be no permanent principles of medical prac- 
tice. The fruits of experience in our day, which 
so many are striving to develop, would be not only 



1 86 CARE OF THE BODY IN HEALTH AND DISEASE. 

useless but an injury to those who are to come after 
us. The medical student and practitioner should 
have a just appreciation of the relative agenc)^ of 
nature and art in the recover} 7 - from disease. It 
is customary and convenient to personify disease; 
speaking of it as an enemy; to be recognized at- 
tack and if possible vanquished. 

Remedies and therapeutical methods are said 
to be curative, as if disease were overcome exclu- 
sively by them. The mind should not be deceived 
by these figurative expressions. In reality re 
co very from disease, is always effected by nature. 
That is — by the agency of processes inherent in 
organism. All that art can do is to remove ob- 
stacles to the operation of natural processes, and 
to promote their favorable operation. Take as 
an example, a remedy which is considered especially 
curative — namely Quinia in periodical fever. This 
remedy, strictly speaking, does not cure the dis- 
ease, using the term cure in its conventional sense, 
but it removes something on which the continu- 
ance of the disease depends. This something 
removed, nature effects the cure. 

As another example, opium does not cure Per- 
itinitis, but by promoting rest of the inflamed part, 
and tolerance of the disease, it affords an aid to 
nature in effecting the cure. In like manner all 
re edies and therapeutical measures exert their 
so-called curative effect in one or the other of these 
two ways. The expression Vis Medicatrix Natura, 
which has been used from time immemorial repre- 
sents the agency of nature in the cure of disease. 
That the physician is the servant, not the master 
of nature ; and that using the term cure in its literal 



NATURE AND ART IN THE CURE OK DISEASE. I 8/ 

sense he has the care of diseases but nature effects 
the recovery have long been recognized true as 
these old Aphorisms prove. 

Let it not be considered that to attribute supreme 
agency to nature is to disparage art, the triumphs 
of the latter are made none the less beneficent and 
brilliant by subordination to the former. 

The achievements of the human mind in every 
direction are dependent upon circumstances and 
laws determined by a higher power. ' ' 

It will be seen from the above quotation that our 
great leaders give credit to nature for a great deal 
in the restoration of patients from disease. 

I might further say that nature is very sensitive 
to powerful drugs that are not indicated; and that 
it is often even the duty of the physician to with- 
hold drugs altogether until there is a positive indi- 
cation for them, A physician may be too judicious, 
but he is oftener given to rashness than to judi- 
ciousness. Other things being equal that is given 
an enlightened physician I would always prefer 
the judicious one. In severe diseases it is some- 
times easy enough to find positive indications for 
medicines, but on the contrary it is often a very 
difficult matter; and in the language of another 
the physician should even be content with doing 
nothing when unable to do good. The duty of the 
physician is to closely observe nature, and when- 
ever she needs assistance, to find out what is re- 
quired and to assist her, 



1 88 CARE OF THE BODY IN HEALTH AND DISEASE. 



CHAPTER XIII. 

THE HEART AND THE CIRCULATION. 

The heart is the great seat of the circulation, 
that pumps the blood to every part of the body. 
It is located in the left side of the chest; its base 
points towards the right shoulder, and its apex 
toward the fifth inter-space of the ribs, a little to 
the right of the left nipple. 

The size of the Heart approximates that of one 's 
fist; it has four cavities, which all combined hold 
about six fluid ounces; there are two receiving 
chambers, and two chambers, which might be called 
delivering chambers. The receiving chambers, are 
called the Auricles, and the delivering chambers 
are called the Ventricles. The Auricles are about 
equal in capacity to the Ventricles; They are thin 
walled and collapse readily on being emptied. The 
Ventricles are thick walled, and do not fully col- 
lapse on being emptied. After birth the right 
and left sides of the heart do not communicate, 
except through the circulation of the blood through 
the tissues by means of the capilaries. Before 
birth there is a hole in the partition between the 
Auricles, called the Foramen Ovale, which admits 
of the blood passing from one side of the heart 
to the other directly. At birth this Foramen 
closes up, and the circulation begins for the adult. 
Each of the cavities are guarded by valves, so 



THE HEART AND THE CIRCULATION. 1 89 

that when the blood is delivered from one cavity 
to another, it is not liable to pass backward. The 
valves between the Auricles and the Ventricles are 
made up of large cusps; three on the right side and 
two on the left, and are held in position by tendon- 
ous cords attached to the inner-side of the cavities 
of the heart; these cords hold the valves so that 
when the cavities are filled, they completely ap- 
proximate, so that in the healthy Heart, when 
the blood is delivered from the Auricles to the 
Ventricles, there is no regurgitation. The valves 
of the Heart open and close with great accuracy, 
and are constantly in motion as long as the Heart 
beats. The two great Arteries, that serve as tubes, 
that carry the blood to every part of the body, 
are also provided with valves that guard the blood 
from returning into the Heart after it has once 
been pumped out. The Heart acts as a double 
force pump; the right Ventricle pumps the blood 
to the lungs by way of the pulmonary artery and 
the left Ventricle pumps the blood to every part 
of the system by way of the Aorta. Some anato- 
mists speak of the circulation as being double; 
that is, the pulmonic circulation and the systemic 
circulation, but in reality the blood makes but one 
circuit, but in doing this the blood has to visit the 
heart twice. In order first to accommodate itself 
to the air, in the capilaries of the lungs, and to 
deliver the oxygen, and nourishment to the various 
parts of the body. I will here give the circulation 
in as brief a way as possible. 

Beginning in the right auricle, the blood is pumped 
down into the right Ventricle, the tri-Cuspid valves 
closing after it, the blood is now pumped out of 



190 CARE OF THE BODY IN HEALTH AND DISEASE. 

the right Ventricle by way of the pulmonary artery 
into the lungs and the Semilunar valves placed at 
the Crifice of the pulmonary Artery close after it ; 
now when the blood reaches the lungs, the air-cells 
are placed in such close relation with the capilaries, 
that carry the blood, that the Carbon Dioxide and 
other waste products are given over to the air in 
the lungs, and the oxygen of the air immediately 
taken in; the blood is here changed in color from a 
maroon to a scarlet hue. The blood is now taken 
up by the minute radicals of the veins, and trans- 
ferred to the left Auricle by means of three veins, 
called the Pulmonary Veins ; the blood is now trans- 
ferred from the left Auricle to the left Ventricle 
and the mitral valves close after it; the left Auricle 
now contracts, and drives the blood out through 
the Aorta to every part of the system ; the Oxygen 
and the nourishments, which the blood may carry 
are now delivered up to the cells of the tissues, 
and the Carbon Dioxide and other waste products 
are delivered over to the blood, the blood now finds 
it's way from the systemic Capilaries into the min- 
ute radicles of the veins, which all converge below 
to form the vena-cava Inferior and all above to 
form the vena-cava Superior, which deliver the 
blood to the right Auricle, the point where I started 
from. 

The Systole of the Heart is the contraction of 
the Auricles and the contraction of the Ventricles, 
it occurs exactly simultaneously in the two Auricles, 
and in the two Ventricles, and is immediately fol- 
lowed by a relaxation or a pause; this is called 
Diastole of the Heart or in other words the Heart, 
while it seems when viewed in action to be constantly 



THE HEART AND THE CIRCULATION. 191 

moving; it has a rest or pause between the beats. 
W hile the Auricles are contracting the Ventricles 
are relaxed, and when the Ventricles are contrac- 
ting, the Auricles are relaxed; the entire cycle of 
the Heart beat only occupies something less than a 
second of time in a healthy man. In little children, 
and persons suffering from disease the cycle is 
greatly accelerated. A careful inspection of the 
beating Heart shows that during its cycle of ac- 
tion certain changes take place in the shape and 
even in the position of its cavities; this is chiefly 
owing to the change of the amount of the blood 
in the cavities, and partly to the form assumed' 
by the muscular wall w T hen contracting. During 
the interval, or pause of the Heart, the Auricles 
are seen to swell gradually, on account of the blood 
flowing into them from the Veins. 

When the Auricles are nearly full, a contraction 
commencing in the great veins approximately 
where they empty into the Heart, takes place and 
passes with increasing force over the Auricles and 
gives rise to their Systolic contraction. The Au- 
ricles suddenly diminish in size, and appear to be- 
come pale. When the blood is being propelled 
through the Auriculo-Ventricular openings, the 
walls of the Ventricles appear to be drawn over 
the liquid mass by the contraction of the muscular 
walls of the Auricles, just as a stocking is drawn 
over the foot by the hands. 

The base of the Ventricles is in this way drawn 
upward; the moment the Ventricles receive their 
full charge of blood from the Auricles, they contract, 
becoming shorter by the movement of the base 
toward the apex and thicker by the elongated cone 



192 CARE OF THE BODY IN HEALTH AND DISEASE. 

becoming rounder. The Great Arteries are at the 
same time distended with the blood from the Ven- 
tricles and elongated, their elastic walls being 
drawn down over the liquid mass. The soft elastic 
tissues are thus in turn made to slide, as it were 
over the fluid, that forms the fulcrum, which the 
muscular walls use as a purchase. 

During the Systole of the Heart, the Ventricles 
rotate slightly on their long Axis, so that the left 
Ventricle comes a little forward, and the lower 
end of the Heart forward and to the right. When 
, the Systole of the Ventricles ceases, they become 
slightly flattened, and the gradual refilling of the 
cavities begin, as there is nothing to prevent the 
blood flowing from the veins through the Auricles 
into the Ventricles, where the pressure is negative. 

The Semi-luner valves, which as before stated 
are placed at the beginning of the two great Arteries, 
that spring from the base of each Ventricle are now 
closed; the large arteries grasp firmly the blood, 
and by their steady resilient pressure force it on 
toward the distal vessels. During this pause the 
Arteries become in a slight degree shorter and draw 
the base of the Heart up again by lengthening the 
Ventricles. The part of the Heart, which changes 
its position the most is the line between the Auri- 
cles and the Ventricles, while the apex remains in 
one position, only making a very slight side and 
forward motion. 

The Heart communicates its motion to the chest 
wall, and the movement can be felt and seen over a 
small area, which is different in different persons, 
which is owing to the thickness or thinness of the 
chest wall; this impulse of the Heart, as the stroke 



THE HEART AND THE CIRCULATION. 1 93 

is commonly called can best be felt in the fifth 
space between the ribs a little to the right side of 
the left nipple. It is found to be precisely simul- 
taneous with the systole of the Ventricles. During 
this period the base of the Ventricles move down- 
ward and become thicker. The Flacid Cone, which 
is formed by the Ventricles during their diastole 
is somewhat flattened against the chest wall, but 
during the systole it becomes rounded and bulges 
forward, and pushes the chest wall before it. This 
change in shape is the chief cause of the impulse 
of the Heart; if the Ventricles be gently held be- 
tween the fingers during their systole a peculiar 
sensation is given by the change of the shape and 
the hardening of the Heart muscle. The mass 
in the Ventricles from being quite soft and com- 
pressible during the diastole suddenly acquires a 
peculiar hardness, owing to the tightness with which 
the muscle grasps the blood, and the greater firm- 
ness of the contracting tissue. This hardening 
of the Heart muscle gives a sensation of a sudden 
enlargement; no matter on what surface the finger 
be placed, the Heart seems to give a slight knock 
in that direction. When grasped between the 
forefinger placed below the Diaphragm and the 
thumb on the Antero-Superior Aspect, the impulse 
is equally felt on all sides. The important item^ 
in causing the impulse are the change in the shape 
of the Ventricles from a flattened to a rounded 
cone, and their simultaneous hardening, which 
helps the movement to be more distinctly felt 
through the wall of the chest. The point in which 
the impulse is best felt corresponds to the anterior 
surface of the Ventricles, which is a considerable 



194 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

distance above the apex. It is therefore erroneous 
to call the impulse the Apex Beat, a term which 
has long been in use. 

The impulses of the Heart is a very useful meas- 
ure in measuring the strength of the systole, and 
therefore is of very great importance to the physi- 
cian. 

The action of the Heart is accompanied by two 
distinct sounds, which can be heard by bringing 
the ear in firm direct contact with the chest wall 
a little to the right of the left nipple or indirectly 
it can be heard by the Stethoscope. One sound 
is to be heard to quickly follow the other, and then 
comes a short pause; these two sounds are spoken 
of as the first and second sounds of the Heart. The 
first sound is heard at the beginning of the systole 
of the Ventricles. It is a low soft prolonged sound 
and is more prolonged than that of the second 
sound. It can be most distinctly heard, over the 
fifth intercostal space a little to the right of the 
left nipple. 

The second sound can be heard at the moment 
when the two sets of Semi-lunar valves are closed 
which is just after the Ventricles have been emptied. 
It is a sharp short sound, and is best heard at the 
second Costal Cartilege on the right side. The 
cause of the first sound has never been made per- 
fectly clear; it has been thought to be produced 
by several factors. The principal events occurring 
at the same time as the first sound may be enumer- 
ated as follows: 

FIRST— The Heart's impulse, SECOND— The 
rush of the blood into the great Arteries, THIRD — 
The contraction of the Heart and FOURTH— The 



THE HEART AND THE CIRCULATION. 1 95 

sudden tension of the Ventricular Chambers and 
the valves between the Auricles and the Ventricles. 

It has already been stated that the impulse of 
the Heart is caused by a sudden change in shape 
and density, and not by a knock against the chest 
wall. It was once thought that a knock against 
the chest wall was the cause of the Heart sounds, 
but is has been found that the sounds are equally 
as clear, when the chest wall has been removed, 
so the beating against the wall has nothing to do 
in the production of the Heart sounds. The char- 
acter of the sound is quite unlike, that which is 
produced by the passage of the blood through the 
openings in the great Arteries. The sound resem- 
bles very much that produced by the muscular 
tone which accompanies the continuous tetanic 
contractions of other muscles of the body. The 
first sound corresponds in time with the contrac- 
tion of the Heart muscle. 

In disease where the Heart muscle is weak, the 
sound becomes faint, although the valves are made 
tense by an intra-ventricular force sufficient to 
overcome the pressure in the Arteries, otherwise 
the circulation would cease. All the evidence we 
have tends to show that the first sound of the Heart 
is produced by the contraction of the muscle tissue 
of the Heart itself; in other words that it depends 
upon some sudden physical change occurring dur- 
ing the contraction of the Heart muscle. On the 
other hand the Auriculo -Ventricular valves are 
made tense at the beginning of the sound and in- 
jury or disease of these valves is said to be associ- 
ated with a weak or altered first sound. This is 
often observed in disease of the Mitral valves^ 



196 CARE OF THE BODY IN HEALTH AND DISEASE. 

The blood is said by some to be necessary for the 
production of this sound, because the closure and 
immediate tension of these valves have a share in 
causing of it. 

The production of the second sound is more 
easily explained, occurring just after the Ventri- 
cles are emptied, it is simultaneous with the closure 
of the Semi-lunar valves at the Aorta and pulmon- 
ary orifices. The blood in the Aorta forcibly 
closes the valves as soon as the pressure in the 
Ventricles begins to wane. This sudden motion 
causes a vibration of the valves, which is rapidly 
checked by the continued pressure of the column 
of the blood. 

BLOOD PRESSURE. 

In regard to the blood pressure, I will here quote 
from Yeo's Manual of Physiology of King's College, 
London : 

"The cause of the blood's motion is simply a 
difference of pressure within the various parts of 
the vascular system, for the Heart acts as the pump 
filling the tubes, represented by the large elastic 
Arteries, which can be more or less distended ac- 
cording as the out-flow is impeded or facilitated 
by the contraction or relaxation of the muscular 
Aterioles, which form the outlet or as the in-flow 
is increased or diminished by the greater or less 
activity of the Heart's action. 

From the foregoing facts and what has been 
said of the direction of the blood current, namely: 
That it flows from Arteries through the Capilaries 
into the veins, it would appear that the pressure 
exceeds that in the Capilaries, and that in the Ca- 



THE HEART AND THE CIRCULATION. 1 97 

pilaries must in turn be greater than that in the A 
veins, the blood flowing in the direction in which 
the pressure becomes less. The different manner 
in which the blood flows from a cut Artery, and a 
cut vein shows that a great difference exists in the 
pressure within the two sets of vessels. When a 
small Artery is cut, and the orifice directed upward, 
the blood spirts out two or three feet in jirks. 
When a vein is cut, the blood only trickles gently 
from the orifice. The force of the flow depending 
much upon the position of the part. 

It is well to remember that bleeding from a vein 
in the leg or arm can be stopped by placing the 
limb in a position more elevated, than the rest of 
the body, so as to prevent the force of gravity from 
acting upon the blood 

By means of a special form of gauge, the Mercu- 
rial Manometer, the exact difference in the pressure, 
exerted by the blood against the vessel walls, in 
the different parts of the circulation can be accur- 
ately estimated, and it has been found by direct 
experiment, that the pressure varies just as one 
will be led to expect from a consideration of its 
Physical relationship, namely: With the direction 
and rate of the current, and the varying width of 
the bed in which it flows. 

The falling pressure observed in the vessels, when 
passing from the left Ventricle into the right Auricle 
is not even. In the Arterioles, it falls suddenly, 
and a great difference exists between the Arterial 
and Venous pressure. It is on account of the per- 
manent high pressure in the Arteries, and compar- 
ative low pressure in the Capilaries and Veins, 
that there is a continuous and permanent flow 



I98 CARE OF THE BODY IN HEAI/fH AND DISEASE. 

through the Capilaries from Arteries to Veins. 
The fundamental problem, that must be clearly 
understood in studying the Dynamics of the circu 
lation is how the high pressure in the Arteries is 
kept up or in otherwords how the Arteries can exert 
so much pressure on the blood, when the Capilary 
out-flow is so wide and free; though coming to the 
left Ventricle from the pulmonary circulation, the 
blood may, on account of the exact co-operation 
of the two sides of the Heart, be regarded as 
pumped out of the Systematic veins thus: as far 
as the general consideration of physical force is 
concerned, the pulmonary circulation may be left out 
of the question. This pumping occurs some seventy 
times per minute, so that a great quantity of 
blood is removed from the veins and forced into 
the Arteries. 

The Ventricles in filling the Arteries have to work 
against considerable pressure, and may be said to 
pump up the blood from low pressure veins into 
the high pressure Arteries, and the result of this 
work is the different pressure in the two sets of 
Vessels. During the contraction of the Heart, the 
Ventricular pressure exceeds that of the Aorta, 
while during the Diastole it falls to that of the 
Auricle, or even of the great veins. The Heart 
then, is the most essential agent in keeping the 
Arteries stretched and over-filled, and in emptying 
the veins. 

The second important factor in enabling the 
Arterial blood pressure to be kept up, is the resili- 
ency of the middle coat of the Arteries. It is only 
on account of the elasticity of their Arterial walls 
that these vessels are capable of being so over- 



THE HEART AND THE CIRCULATION. 1 99 

filled, and because of the perfect resiliency of the 
elastic coat that they are able to exert such power- 
ful pressure on the blood for such an unlimited 
time. 

If the Arteries were rigid tubes, to distend them 
with a fluid in itself, in-elastic w r ould of course be 
out of the question. 

The outflow from the Distal extremity would 
only take place, when the additional charge of blood 
is injected by the Heart. With each contraction 
the Ventricle overcomes Arterial pressure, and 
further stretches the elastic Artery. The act of 
injecting the blood into the Aorta only occupies 
about one quarter of each Heart beat. The Semi- 
lunar valves bear the pressure of the blood in the 
Aorta for the rest of the time. The whole force 
of the Ventricles is therefore used up in causing 
Arterial extension. During the greater part of 
the Hearts cycle, the Arteries are closed at their 
cardiac end by the Aortic valves, and open at their 
distal end to the Capilaries. As the result of this, 
the blood flows constantly out of the distended 
Arteries through the Capilaries into the veins, and 
tends to equalize the pressure in the veins and the 
Arteries, but why does this constant outflow allow 
the pressure in the Arteries to fall to the level of 
that in the veins? Or in other words what is the 
impediment offered to the escape of the blood that 
thus keeps the Arteries distended? If the Arteries 
and veins w r ere a set of continuous wide tubes of 
similar construction and capacity throughout, it 
would be impossible for the Heart to empty the 
veins, overfill the Arteries and establish the great 
pressure difference that normally exists. There- 



200 CARE OF THE BODY IN HEALTH AND DISEASE. 

fore some resistance equal to the pressure must 
be offered to the flow of the blood from the Arteries 
into the veins. This resistance is made up of 
several items, of which one alone; namely the vital 
contraction of the arterioles is sufficient to keep 
up the Arterial pressure. 

No doubt, the great increase of surface, over 
which the blood has to move in the Capilaries, and 
the pressure exercised upon them by the surround- 
ing elastic tissues have influence in impeding the 
emptying of the Arteries, but the contractility of 
the Arterioles is the most important item as may 
be seen in the following consideration: 

The resistance offered by the Capilaries is insig- 
nificant, when compared with the Arterial blood 
pressure, for the increase of friction accompanying 
their greater extent of surface is counter-balanced 
by the decrease of friction, depending upon the 
great total capacity of the Capilaries in comparison 
with that of the small Arteries. The Capilary 
resistance alone, is therefore not sufficient to re- 
strain the blood from rushing into the veins. This 
is seen when the Arterioles are paralyzed, by the 
destruction of the nervous mechanism controlling 
them. The blood then flows readily through the 
Capilary net-work; the veins become engorged; 
the Arterial blood pressure falls, and the circulation 
comes to a stand-still. In spite of the Heart's 
more rapid beats, we know- that beyond the Ar- 
terioles the pressure falls suddenly, and in Capilary 
net-work, it is always very low. The four great 
factors in keeping up the Arterial blood pressure 
may be thus enumerated: First, the Heart beat, 
Second, perfect Aortic valves, Third, the elastic 



THE HEART AND THE CIRCULATION. 201 

resiliency of the large Arteries, Fourth, the resist- 
ance offered by the contraction of the muscular 
Arterioles. " 

The heart's beat. 

If any factor in the make up of the Heart, which 
has been described fail to perform its office, the 
mechanism of the circulation is at once impaired. 
The Heart's beat may be stopped by stimulation 
of the inhibatory nerve fibers of the Vagus or Pneu 
mogastric nerve, in which case the blood pressure 
rapidly falls. Weakness of the Heart b^at may 
arise from diseases of the muscles of the Heart, as 
for example in Fatty Degeneration. 

Any insufficiency of the Aortic valves that per- 
mits or allows the blood to flow backward into the 
Ventricle, allows the Arterial pressure to fall be- 
tween each Ventricular Systole, which gives rise 
to the characteristics of a pulse with unfilled Ar- 
teries, as it is called by the clinical physician. The 
resiliency of the Arterial coats may also be destroyed 
to a certain extent by a degeneration of the tissue, 
in which case the large Arteries become greatly 
distended, and unable to exert their normal steady 
pressure on the blood. Injury of any of the Su- 
pre e Nervous Centers are often associated with 
paralysis of the muscular Arterioles and consequent 
fall of blood pressure, but the effect upon the blood 
pressure of dilatation of the small Arteries can best 
be seen by experimenting on the nerves, which 
control their contraction. If paralysis or inhibition 
of the vaso-motor mechanisms be experimentally 
produced, the result on the Arterial pressure is 



202 CARE OF THE BODY IN HEALTH AND DISEASE. 

the same, that is a sudden fall, which may become 
as low as the pressure of the atmosphere. 

The chief opposition to the out-flow of blood 
from the Arteries, being removed they cease to be 
tense, even though the Ventricles continue to beat 
and pump the blood into them. The amount of the 
work done by the Heart is enormous; physiologists 
have made calculations as to the amount of work 
done by the Heart of a man under various circum- 
stances, as it is affected by labor, occupation and 
the general physique of the individual, but most 
likely if they were produced here, they would ap- 
pear incredible to the average reader, for that rea- 
son I will not produce them. 

There is a difference in the size of the Heart in 
different individuals; people of a strong, stocky 
build usually have larger Hearts and consequently 
stronger pulse than those of a spairmake. The 
Hearts of men, as a rule are larger than those of 
women, and consequently their pulse are a little 
slower and stronger. 

Persons with strong Hearts do not often suffer 
from cold hands or cold feet, and are less subject 
to excitement, than those with weak Hearts. Those 
with weak Hearts, as a rule are easily affected by 
cold, often suffer from cold hands and feet, and are 
generally more excitable than those with strong 
Hearts. 

THE ARTERIAL PULSE. 

Each contraction of the Ventricle on the left 
side of the Heart sends a quantity of blood into the 
Aorta, and communicates a stroke to the vessel. 
The incompressible fluid causes the tense Arterial 



THE HEART AND THE CIRCULATION. 2O3 

wall to distend still further, but the shock to the 
column of blood is not transmitted on directly by 
the fluid, but causes the elastic walls of the Arteries 
to yield locally and thus is converted into a wave, 
which passes rapidly along those vessels. This 
motion in the walls of the vessel can be felt wherever 
the Artery can be reached by the finger, but best 
where the Artery is superficial, and some unyield- 
ing structure as bone lying underneath for counter 
pressure, as the radial Artery of the wrist and of 
the temporal as it passes in front of the ear. The 
radial at the wrist for sake of convenience is usually 
chosen for clinical purposes. 

The motion communicated to the Arteries, that 
has just been described is called the pulse. It 
consists of a simultaneous widening and lengthen- 
ing of the Artery. The Arteries near the Heart are 
more affected by the pulse wave, than those more 
remote from it, the wave becoming fainter and 
fainter, as it travels along the branching Arteries. 

In the smallest Arteries it is hardly to be recog- 
nized under ordinary circumstances, and in the 
Capilaries and veins it is completely absent. The 
diminution in the pulse wave in the smaller Arteries 
chiefly depends upon the fact that the force of the 
wave is used up, in distending the succeeding 
parts of the Arteries. In the small Arteries the 
extent of service to which the pulse wave is com- 
municated is great and therefore the wave is much 
decreased. So long as the Arterioles are contracted 
to their normal degree, no pulsation is communi- 
cated to the Capilaries, because the wave reaching 
the Arterioles is reflected by them. The pulse 



204 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

wave can easily be shown to take some time to pass 
along tHe vessels. 

Near the orifice of the Aorta the Arterial disten- 
sion occurs practically at the same time as the 
Ventricular systole, but even with comparative 
or rough methods the radial pulse can be noticed 
to be a little later than Heart beat. The differ- 
ence of time between the pulse between the facial 
Artery and the Dorsal Artery of the foot, has been 
estimated at one sixth of a second, and the differ- 
ence of the distance of these vessels from the Heart, 
as the blood travels by way of the vessels, is be- 
tween two and three feet, that is; a pulse wave 
travels more than 30 feet per second. The time 
that the wave takes to pass any given point must 
be equal to the time taken to produce it, that is to 
say, the time the Ventricle occupies in sending a 
new r charge of blood into the Aorta', which is about 
one third of a second, knowing the rate at which 
the wave travels and the time it takes to pass any 
given point, its length may be calculated, thus the 
pulse wave reaches the most distant Artery in about 
one sixth of a second. 

The average pulsations in the adult man is about 
72 beats per minute; it is faster sitting and stand- 
ing than it is lying. In little infants just born it 
ranges from 130 to 140 beats per minute. It is 
greatly exaggerated by many diseases, and the 
knowledge of it is highly useful to the physician; 
not only as an indication for medicines, but also 
the relation it bears to diagnosis and prognosis. 



ANIMAL HEAT. * 205 



CHAPTER XIV. 

ANIMAL HEAT. 

The bodies of most animals as well as that of 
man are considerably warmer than the medium in 
which they live. Part of the energy set free by the 
chemical changes in the animal tissues appears as 
heat and is devoted to this purpose. Warm blooded 
animals are those which preserve an even tempera- 
ture; man and a number of the lower animals have 
a temperature in the Heart of one hundred degrees 
Fahrenheit, but under the tongue or arm-pit, which 
is generally used for taking the temperature, the 
blood is found to have lost about a degree and half, 
so the temperature by our clinical thermometers 
in a healthy individual is ninety-eight and a half 
degrees Fahrenheit Thermometer; birds of flight 
have a temperature of two or three or four degrees 
higher than man. 

Cold-blooded animals on the other hand are 
those in which the temperature is considerably 
affected by or more or less closely follows the me- 
dium in which they live. 

The blood of cold-blooded animals is usually 
from one to ten degrees above the medium in which 
they live. 

They produce small quantities of heat, and since 
they have no special plan for regulation, it does 
not remain in any fixed standard, as it does in the 
warm-blooded animals. 



206 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

In every part where active oxidation takes place, 
heat is rapidly generated. On account of the slight 
variation that occurs in the temperature of man, 
all the changes can be measured by a thermometer, 
having a short scale of only about twenty degrees, 
each degree of which occupies a considerable length 
on the instrument, so that very slight variations 
may be easily appreciated. Such Thermometers 
with an arrangement for self-registering the max- 
imum attained by the column of Mercury are in 
daily use by the physician for clinical purposes, 
for the temperature of the body is now a most im- 
portant aid in the diagnosis and prognosis of a 
large class of diseases, as heat is constantly being 
lost at the surface of the body; the skin is colder 
than the deeper parts, and in order to avoid varia- 
tions by this surface loss, the thermometer should 
be placed in some sheltered part of the body, as 
in the arm-pit, or under the tongue or in the bowel 
or the Vagina, still allowing a degree and a half 
for the loss sustained in the blood coming from 
the Heart to the points mentioned. The tempera- 
ture of the whole body normally undergoes certain 
variations. Some of which are regular and period- 
ical, depending upon the time of day, the taking 
of food and the age of the individual, also mental 
and bodily exertions, exert an influence on the 
temperature. The temperature is highest between 
four and five in the afternoon and lowest between 
two and four A. M. 

The transition being very gradual ; this diurnal 
variation, which in a healthy individual does not 
exceed more than one degree, but in a number of 
diseases it is greatly exaggerated. The tempera- 



ANIMAL HEAT. 207 

ture rises after a meal and falls during fasting. 
During starvation the temperature sinks gradually 
until the death of the individual. 

The temperature is highest at birth, and falls 
something over one degree Fahrenheit Thermometer 
between that and the age of fifty years. 

Muscular exertion, which gives the individual 
the sensation of great warmth, only changes the 
temperature of the blood from one half to one 
degree. Mental exertion is also said to cause a 
rise of temperature; very slight differences in the 
heat of the blood may be brought about by varia- 
tions in the surrounding temperature. The ab- 
normal high temperature of high fever is much 
more easily affected by changes in the rate of re- 
moval of the heat from the body, than is the normal, 
hence the therapeutic value of cold applications 
in this class of diseases. The temperature of differ- 
ent parts of the body also varies, and depends upon 
the following circumstances : 

First, the amount of blood flowing through them 
the blood being the carrier of warmth from one 
part of the body to another supplying heat where 
it is lost and conveying material to those parts, 
where the heat is generated. 

Second, the amount of heat produced, that is to 
say the activity of its tissue change. 

Third, the amount of heat lost, which depends 
on the extent of surface, the external temperature, 
and the power of conduction of, and the capacity 
for heat of the surrounding medium; from this it 
is clear, that the deeper parts of the body, where 
active chemical changes take place, and which 
are protected from exposure must be warmer than 



208 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

the exterior, which is constantly giving out its 
heat. The blood, which flows through the surface 
vessels is cooled, and that which flows through the 
interior of the body is warmed, thus the skin is 
usually about ninety-seven and one-half degrees 
Fahrenheit, while beneath the tongue it is about 
ninety-eight and one-half. The temperature of 
the blood therefore varies within narrow limits, 
according to the part of the body through which 
it has recently passed. 

The mean temperature of the blood is higher 
than that of any of the tissues ; the temperature of 
an organ varies with the state of its activity. 
During their active state, the glands receive more 
blood, and undergo more active change, so that 
they become warmer. It has already been stated, 
that the general affect of the tissue changes of the 
body is a kind of combustion in the tissues, of 
certain substances obtained from the food, such 
as Proteids, Fats and Carbo-hydrates. These 
combustible substances are capable of being 
burned in the open air or cause to unite with Oxy- 
gen, so as to produce heat, and are thus converted 
into Carbon-dioxide and water. 

Now, in the body of man and other warm-blooded 
animals, this oxidation process goes on in a grad- 
ual and modified way, and the end products of 
the process can be recognized as Carbon-dioxide 
eliminated from the Lungs, and as water and Urea 
gotten rid of by the Kidneys. 

The general tendency of the chemical changes 
in the tissues, is such as will set free energy in the 
form of heat, and a considerable part of the food- 



ANIMAL HEAT. 209 

stuffs of all warm-blooded animals are used up in 
generating this heat. 

THE MAINTENANCE OF A UNIFORM TEMPERATURE. 

In order that the vital processes of man and other 
warm-blooded animals shall go on in a normal 
manner, it is necessary that their mean temperature 
remain nearly the same, and we have seen under 
ordinary circumstances that it varies only about 
one degree above or below the standard. Not- 
withstanding the changes taking place within the 
temperature around us, thus we are enabled to live 
in any climate; either cold or hot if our body tem- 
perature remains unaltered, we suffer no immediate 
injury. 

But there is a limit to this power of maintaining 
a uniform standard temperature, for instance if a 
man were kept for some time in a moist medium, 
where evaporation cannot take place, but a little 
higher than his body, his temperature soon begins 
to rise, and he dies with the signs of disturbance 
of breathing and convulsions. 

Since the variation of more than one or two 
degrees, in the temperature of our bodies interferes 
with the vital activity of the controlling tissues 
in the nervous centers, it is of the utmost impor- 
tance, that sufficient means for the regulation of 
the mean temperature of our bodies should exist. 

The temperature of the body must necessarily 
depend on the relations existing on the amount of 
heat generated in the tissues, and organs and the 
amount allowed to escape at the surface, and these 
must closely correspond, in order that the heat of 
the body may remain uniform. 



2IO CARE OF THE BODY IN HEALTH AND DISEASE. 

The maintenance of a uniform temperature may 
be accomplished : 

First, by variations in the heat income, so ar- 
ranged as to make up for the irregularities of ex- 
penditure, or second, variations in the loss to com- 
pensate for the differences of heat generated. 
Since the temperature and moisture of our surround- 
ings are constantly varying between tolerably 
wide limits, the amount of heat given off by our 
bodies will also vary. In cold damp weather a 
great quantity of heat is lost in comparison with 
that which escapes from the body, when the air 
is dry or warm. 

If the heat generated had to make up for the 
heat loss, we should expect to find a correspond- 
ingly great difference in the amount of heat gener- 
ated at different times of the year. 

No doubt, we have some evidence in the keener 
appetite or use of more fuel, and the natural ten- 
dency to active muscular exertion during cold 
weather shows that a greater amount of combus- 
tion takes place in winter than in summer. If 
the preservation of a uniform body temperature 
depended completely upon the variations in the 
amount of income keeping pace with the variation 
in expenditure, we would find it inconvenient to 
set our muscular and glandular tissues in action, 
except when the external temperature is such 
as will enable us to get rid of the increased heat 
following their activity. 

It, no doubt appears that the general tissue com- 
bustion, as measured by the amount of Carbon- 
dioxide given off, increases when we are placed in 
colder surroundings ; such for instance, as in taking 



ANIMAL HEAT. 211 

of a cold bath, but it is likely, that the variations 
in heat income have but a secondary influence on 
the body temperature. If the rate of income have 
any regulating influence, we have no knowledge 
of the manner in which such influences are exerted. 
On the other hand we know that the amount of heat 
expenditure may be varied by mechanisms, which 
are almost self -regulating. It has already been 
indicated, that the great loss of heat, generated 
by the body is lost by the parts in contact with 
the air, such as the skin and lungs. In these places 
the warm blood is exposed to the cool air, and 
loses heat by radiation, conduction and evapora- 
tion. It is clear that the greater the quantity of 
blood thus exposed to cooling, the greater the 
amount of heat would be lost in a given time. If 
we review the circumstances, which interfere with 
the uniformity of the temperature of the body, 
we shall see that each is accompanied by certain 
physiological actions, which tend to compensate 
for any disturbing influence. 

The chief event tending to make our temperature 
exceed or fall short of its normal standard, may 
be enumerated as follows : 

A casual increase in the heat income may be 
induced by any increased chemical activity, no- 
tably the action of the muscles and large glands. 
When this increased heat is communicated to it, 
the warm blood by the help of certain nerve centers 
brings about the following results: 

First an acceleration of a respiratory movement 
increasing the amount of cold air to be warmed, 
and saturated with moisture by the air passages 
and facilitating the escape of the surplus caloric. 



212 CARE OF THE BODY IN HEALTH AND DISEASE. 

Second relaxation of the cutaneous Arterioles, 
thus exposing a greater quantity of blood to the 
cooling influence of the air. 

Third a greater rapidity of the Heart heat, giving 
a greater quantity of blood to the air passages and 
to the surface vessels. 

Fourth an increase in the amount of sweat se- 
creted, affording opportunity for greater surface 
evaporation. 

As examples of these points may be mentioned, 
active muscular exercise, which experience shows 
is always accompanied by quick breathing, the rapid 
Heart's action and a moist skin. 

The increased production of heat in fever gives 
rise to the same results, with the exception of the 
secretion of sweat, which is an important deficiency 
in the heat regulating arrangements, and has much 
to do with the high temperature of the disease. 

When a lesser quantity of heat is produced, ow- 
ing to the inactivity of the heat producing tissues, 
the reverse takes place, that is the respiration and 
Heart's action are slow, the skin is pale and dry, 
so that little can escape. 

When the temperature of the air rises much 
above the average, the escape of the heat is corres- 
pondingly hindered, and when the general body 
temperature begins to rise by this retention of 
caloric, we have the sequence of events given in 
the last paragraph, but before the blood can be- 
come warm by the influences of the increased ex- 
ternal temperature, the warm air, by stimulating 
the skin, brings about certain changes, independent 
of the body temperature, which check the tendency 
to an abnormal rise. This can be shown by the 



ANIMAL HEAT. 21 3 

local application of external heat, which causes a 
rush of blood to the skin and copius sweat secre- 
tion may be induced in a part. This is brought 
about by impulses sent directly from the skin to 
the centers regulating the Vaso-motor and secre- 
tory mechanisms, and thus causing dilation and 
secretive activity. When the atmosphere becomes 
very warm, all the vessels of the skin dilate simul- 
taneously and the escape of heat is greatly increased, 
while at the same time so much blood being occu- 
pied in circulating through the skin, the deeper 
heat-producing tissues are supplied with less blood 
and therefore generate a lesser quantity of heat, 
thus a marked rise in the external temperature, 
which at first sight, would seem to impede the es- 
cape of heat from the body, really facilitates it. 

By causing through the Vascular and Glandular- 
Nervous mechanisms of the skin, a greater expos- 
ure of the blood to the cooler air, and a greater 
quantity of moisture to be evaporated from the 
warm skin. 

When the temperature of the air reaches that 
of the body, the only way that we can dispose of 
the heat generated in our bodies, is by evaporation 
for radiation and conduction becomes impossible. 
In animals like man, whose cutaneous moisture is 
great, external heat seldom causes marked changes 
in the rate of breathing, but animals, whose cuta- 
neous secretion is limited, external heat distinctly 
affects their respiratory movements* as may be 
seen by the panting of a dog on a very warm day 
even when the animal is at rest. Almost more 
important than facilitating the escape of heat, in 
very warm weather, are the arrangements for pre- 



214 CARE OF THE BODY IN HEALTH AND DISEASE. 

venting its loss, when the surroundings are unusu- 
ally cold. In this case, the cold acting as a stimulus 
to the Vaso-constrictor nerve agencies of the skin, 
causes the blood to retire from the surface, and 
fill the deeper organs, where more heat is produced. 

This bloodless skin and the underlying fat, then 
act as a non-conducting layer, protecting the warm 
blood from the cooling exposure, and at the same 
time the generation of sweat is controlled by a 
special nerve mechanism which hinders evapora- 
tion, and checks the secretion and in this way 
enables the body to remain at the normal standard 
temperature. It would then appear, that the chief 
factors regulating our temperature, belong to the 
expenditure department, and may be said to be 
first a variation in the quantity of the blood ex- 
posed to be cooled, and secondly to a variation in 
the quantity of moisture produced for evaporation. 
These regulaters have to compensate not only for 
differences of external temperature, but also for 
great fluctuations in the amount of heat produced 
in the body. The regulating power of the skin is 
only sufficient for the maintenance of a uniform 
temperature within certain limits. When these 
limits are passed by the rise or fall in the surround- 
ing medium, the preservation of the uniform tem- 
perature soon becomes impossible. These limits 
vary in different animals, many of which have 
special coverings, that protect them from external 
influences, and retain their warmth, w^hen the 
temperature is below the freezing point. 

In man, the limits vary according to many ior- 
cumstances, both extremes of age are more sensi- 
tive to changes of temperature. By imitating 



ANIMAL HKAT. 21 5 

with clothing, the natural protection with which 
some animals are endowed, we can aid the normal 
regulating factors and bear much greater extremes 
of temperature with safety or even comfort. It 
is somewhat surprising that our bodies are always 
at the same temperature, no matter how hot or how 
cold we may feel ; no difference how cold the weather 
or how hot the weather, in otherwords no difference 
the season nor the climate, a man's temperature 
is the same everywhere and in all seasons, so long 
as he remains in health. 

When we feel hot, the vessels of our skin are full 
of warm blood, and this communicates to the cuta- 
neous nerves the sensation of general warmth, 
on the other hand, when the vessels of the skin are 
empty, the Sensory Nerves are directly affected 
by the cold external air. Since the full or empty 
state of the vessels of the skin depends generally 
on the heat or cold of the air, w^e use the expression, 
"It is hot or cold" and we are hot or cold, because 
both ideas arise from the state of the skin, but we 
can make ourselves warm by violent exercise on 
a frosty day, because we generate so much heat 
by muscular action, that the cutaneous vessels 
have to be dilated in order to get rid of the surplus, 
and our skin vessels being full, we feel warm. Our 
feelings, when we say we are warm or cold, simply 
depend upon our cutaneous vessels being full ox 
empty of warm blood. 



21 6 carE of the body in heai/th and disease. 



CHAPTER XV. 
sensations of the skin. 

The sensations arising from many impulses com- 
ing from the skin are grouped together under the 
sense of touch. This special sense, may be resolved 
into a number of specific sensations, each of which 
might be considered a distinct kind of feeling, but 
is for the most part, regarded as simply giving the 
different qualities to the sensation excited by the 
skin. 

Tactile sensation, or the sensation proper, by 
means of which we appreciate a very gentle con- 
tact recognize the locality of stimulation, and judge 
of the position and form of bodies ; second, the sense 
of pressure, and third, the temperature sense. 

The variety of perceptions derived from the cu- 
taneous surface, and the great extent of surface 
capable of receiving impressions, make the skin 
the most indispensable of the Special Sense Organs, 
although we value this source of our knowledge 
but very little. If we could not place our. hands 
as feelers, on near objects to investigate their sur- 
faces, we should lose an important source of infor- 
mation, that contributes largely to our visual 
judgment. We think we know by the look of a 
thing what we originally learned by feeling of it. 
If our conjunctiva did not feel we should miss its 
prompt warning, and our voluntary movements 
could not protect our eyes froi. many unseen in- 



SENSATIONS OF THE SKIN. 21 7 

juries, that normally never trouble us. If the 
skin were senseless, it would require constant 
labor and effort to hold anything in our hands, 
and our powers of standing and walking would 
be seriously impaired, and how utterly cut off from 
the world would we be, were we incapable 
of feeling heat and cold. 

By the sense of locality is meant our power of 
judging the exact position of any points of contact, 
which may be applied to the skin, thus if a point 
of a pin be gently laid on a sensitive part of the 
skin, we know at once when we are touched, and 
if a second pin be applied in the same neighborhood, 
we feel the two points of contact, and can judge 
of their relative position. When we feel anything 
we receive impulses from many points of contact 
bearing varied relationship to each other, and thus 
became conscious of a rough or a smooth surface 
The delicacy of the sense of locality differs materi- 
ally in different parts of the skin. It is most ac- 
curate in those parts, which has been used as touch 
organs, and has developed through the course of 
many generations. 

To explain better the sense of locality, it has 
been supposed that sensory circles are made up of 
numerous small areas, forming a fine mosaic of 
touch-field, each of which is supplied by one nerve 
fiber, and that a certain number of these little 
fields must intervene between the stimulating 
points, and an object in contact with it. 

In order that the supreme centers in the brain 
be able to recognize the impulses as distinct, for 
although every touch field is supplied by a separate 
nerve fiber, which carries these impulses to the 



21 8 CARE OF THE BODY IN HEAI/fH AND DISEASE. 

brain, and is therefore quite sensitive, the arrange- 
ment of the cells in the Sensorium is such that the 
stimuli carried from two adjoining touch fields, 
are confused into one sensation, thus when an edge 
is placed on our skin, we do not feel a series of 
points, corresponding to the fields, with which it 
comes in contact, but the confusion of the stimuli 
gives rise to an uninterrupted sensation, and we 
have a right conception of the object touched. 

There seems to be a reason for separating the 
perception of differences in the degree of pressure 
exercised by a body from the simple tactile or 
local impression. If we support a part of the body 
so that, no muscular effort be called into play, in 
the support of an increasing series of weights, placed 
upon the same area of skin, we can distinguish 
tolerably accurately between different weights. 
It has been found, that if a weight of about 30 
grams, which is nearly an ounce in Apothecaries' 
weight, be placed on the skin, a difference of about 
one gram can be recognized, which equals some- 
thing over 15 grains, that is we can distinguish 
between 29 and 30 grams, if they are applied soon 
after one another. If the weights employed are 
smaller, less difference can be appreciated; if larger 
weights are used, the difference must be greater, 
and it appears, that the weight difference always 
bears the same proportion to the absolute weight 
used. 

We can perceive a difference between seven and 
one fourth and seven and one half and fourteen 
and .a half and fifteen and twenty nine and thirty 
and fifty eight and sixty; the discriminating power 
decreasing in proportion as the weights are increased 



SENSATIONS OF THE SKIN. 21 9 

in size. One of the reasons why the sense of pres- 
sure is regarded as distinct from that of locality, 
is that the former is found not to be most keenly 
developed in the parts where the impressions of 
locality are most acute, thus judgment of pressure 
can be more accurately made with the skin of the 
fore-arm than with the tip of the finger, which 
is nine times more sensitive than the former to 
tactile impressions; while the skin of the abdomen 
has an accurate sense of pressure though dull to 
ordinary tactile sensation, it has been said above, 
that the weights by which pressure sense is to be 
tested, should be applied rapidly one after the other. 
This fact depends upon the share taken in the men- 
tal judgment, by the function we call memory. 

In a short time the recollection of the impression 
passes away, and there no longer exists any sensa- 
tion, with which the new impression can be com- 
pared. At best, we can form but imperfect judg- 
ments of pressure by the skin impressions alone 

When we want to judge the weight of a body, 
we poise it in the free hand, which is moved up and 
down, so as to bring the muscles, which elevate it, 
in repeated action. In this way we call into action 
a totally different evidence, this is the amount of 
muscle power required to raise the weight in ques- 
tion, and we find that we can arrive at much more 
accurate conclusions by this means. The peculiar 
recognition of how much effort is expended is com- 
monly spoken of as muscular sense, which may 
arise from a knowledge of how much voluntary 
impulse is expended in exciting the muscles to 
action, but more likely it depends upon afferent 
impulses arriving at the Sensorium from the mus- 



220 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

cles. By this means we aid the pressure sense 
in arriving at the accurate conclusion of the weight 
of bodies, so that in the free hand, we can disting- 
uish between thirty-nine grams and forty grams. 

The two chapters to follow on Temperature 
Sense and General Sensations, I will quote from 
Yeo's Manual of Physiology. 

TEMPERATURE SENSE. 

"We are able to judge of the difference of Tem- 
perature in bodies, which come in contact with 
our skin. Our sensations have no accurate stand- 
ard for comparison ; we are unable to form an exact 
conception of the absolute temperature of the sub- 
stances we feel. 

The sensation of heat or cold, derived from the 
skin itself, without its coming into contact with 
air of moderate temperature varies with many 
circumstances, and because of these radiations, 
the powers of judgment of high or low temperature 
must be imperfect. The skin feels hot, when its 
blood vessels are full ; it feels cold, when they are 
comparatively empty. An object of constant tem- 
perature can thus give the impression of being 
hot or cold, according, as the skin, itself is full or 
empty of warm blood. But independent of any 
very material change in the blood supply of the 
cutaneous surface of a part, any change in the 
temperature of its surroundings causes the sensa- 
tion of change of temperature, which is however 
a purely relative judgment. 

Thus if the hand be placed in cold water, we have 
at first a sensation of cold, to which however the 
skin of the hand becomes accustomed, and no 



SENSATIONS OF THE SKIN. 221 

longer feels cold, if now the hand be placed in water 
somewhat warmer, but not higher in temperature 
than the atmosphere, we have a feeling of warmth. 
If the hand be placed in as hot water as the skin 
can bear, it feels at first, unpleasantly hot, but this 
feeling soon passes away, and the sensation is com- 
fortable. If from this hot water, it be placed again 
in the water of the air temperature, that which 
before felt warm, feels very cold. 

An important item in the estimation of the tem- 
perature of an object by the sensations, derived 
from the skin, depends upon whether it be a good 
or a bad conductor of heat. Those substances, 
which are good conductors, and therefore when 
colder than the body, quickly rob the skin of its 
heat, are said to feel cold, while badly conducting 
bodies of exactly the same temperature do not 
feel cold; it is then the rapid loss of heat, that gives 
rise to the sensation of cold. The power of the 
skin in recognizing changes of temperature is very 
accurate, although the power of judging the abso- 
lute degree of temperature is very slight. By 
dipping the finger rapidly into water of varying 
temperature, it has been found that the skin can 
distinguish between temperatures, which differ by 
only half a degree Fahrenheit Thermometer. The 
time required for the arrival of temperature im- 
pressions at the brain is remarkably long, when 
compared with the rate, at which ordinary tactile 
impulses travel. 

To judge satisfactorily of the temperature of an 
object, we must feel it for some time. There must 
be special nerve endings, which are capable of receiv- 
ing heat impressions, because warmth applied to 



222 CARE) OF THE BODY IN HEAI/TH AND DISEASE. 

the nerve fibers, themselves, is not capable of giving 
rise to the sensation of heat. 

Thermic Stimuli, no doubt do effect nerve fibers, 
but only cause the sensation pain, when applied 
to them. These nerve endings are not the same 
as those, that receive touch impressure impressions, 
because the appreciation of differences of tempera- 
ture is not very delicately developed in the parts 
where the tactile sensations are most acute; thus 
the cheeks and the eyelids, are especially sensitive 
to changes of temperature. A fact known by peo- 
ple, who want a ready gauge of the human body, 
a barber approaches the curling tongs to his cheek 
to measure its temperature before applying it to 
the hair of his client. The middle of the chest is 
very sensitive to heat, while it is dull in feeling 
tactile impressions. The hand is far from being 
the best gauge of temperature, for heat apprecia- 
tion is not developed in due proportion to the keen- 
ness of its tactile sensibility. The larger surface 
exposed to the change of temperature, the more 
accurate the judgment at which we can arrive, the 
slightest changes being at once recognized, when 
the entire surface of the body is exposed to them. 

The foregoing facts are well known to persons 
in the habit of testing the temperature of a warm 
bath, without the aid of a Thermometer. They 
do not use a limited surface of a sensitive tactile 
finger tip, but plunge the entire arm into the water. 
The elbow indeed is the common test used by nurses 
in ascertaining that the water, in which they are 
about to wash an infant is not too warm for that 
purpose. Great extremes of heat or cold, such in 
fact as would act as Stimuli to a nerve fiber do not 



SENSATIONS OF THE SKIN. 223 

give rise to sensations of different temperatures, 
but simply excite feelings of pain, thus if we plunge 
our hands into a freezing mixture, or into extremely 
hot water, it's difficult to say at once whether they 
are hot or cold; in both cases pain being the only 
sensation produced. 

GENERAL SENSATIONS. 

We call general sensations those feelings pleas- 
urable or otherwise, which can be excited without 
our being able to refer them to external objects. 
Compare their sensations with those of the Special 
Senses or even describe their exact mode of per- 
ception. Under this head are enumerated, pain, 
hunger, thirst, nausea, giddiness, shivering, titra- 
tion, fatigue, etc. Of these, only pain is com- 
monly referred to any given part, and the attempt 
to localize pain with exactness soon shows how 
very different is our power in this respect, in the 
case of pain and in the case of tactile impressions, 
thus when we strike our funny-bone, the Ulner 
nerve passing over the Condyle of Humerus, by 
the tactile impressions of the skin, we knov^ the 
elbow is the injured part, but the locality of the 
pain is not exactly to be determined, for it shoots 
down the arm to the little finger, and is indefinitely 
spread over the region to which the nerve is dis- 
tributed. In studying the laws, which govern the 
perception of painful impressions, we must make 
the experiments upon ourselves; since we alone 
can form conclusions from the sensations produced. 

The best way to carry out experiments upon 
pain, is to use extremes of temperature, as we can 
thus graduate the stimulation. The application 



224 CARE) OF THE BODY IN HEAI/fH AND DISEASE. 

of a liquid over 50 degrees Centigrade Thermometer 
or below two degrees causes pain. 

The suddenness of application to the part and 
its duration, and the extent of surface, as well as 
the previous temperature, have important influ- 
ence in the amount of pain produced. The various 
kinds, with which we are all more or less familiar 
seem to be related in some way to their mode 
of production, but we are unable to assign any 
definite cause for these differences of character, 
thus, though such terms as shooting, stabbing, 
burning, throbbing, boring, racking and dragging 
pain are frequently used and may be of diagnostic 
value. We have only an indistinct knowledge 
that throbbing depends on excessive vascular dis- 
tension of the part, that sharp pains are produced 
by sudden excitation of a sensitive part, and the 
dull pains by the more permanent stimulation of 
the part less well supplied with nerves; further 
pain, as we think of it, is a complex mental process 
made up of many items, such as real sencory im- 
pressions, fear, disgust, etc. When a finger 
is to be lanced, patients often cry out most loudly, 
before they are touched with the knife, and show 
intense feeling, when they look at the blood, flow- 
ing from the wound. Hunger and thirst are pecu- 
liar and indefinite sensations, which are experi- 
enced, when some time has elapsed since food or 
drink has been taken. The exact part of the nerv- 
ous system, in which these impressions arise have 
not been determined. They are, however said to 
be associated with peculiar sensations in the stom- 
ach and throat respectively. 

In the same way the venereal appetite, though 



SENSATIONS OF THE SKIN. 225 

associated with local sensations, cannot be referred 
to any one part of the nervous system. Nausea 
is also a sensation, which cannot be attributed to 
any part of the nervous centers. It commonly 
arises in reponse to afferent impulses, such as smell, 
sight, taste, phyrangeal gastric or vicereal irrita- 
tion, and is antagonistic to the appetites just named. 

All the sensations that give rise to or precede 
nausea, are associated in our minds with disagree- 
able impressions, and no doubt, mental operations 
have much to do with its production. 

A child free from affection may be heard to say 
of a Castor Oil bottle, which in itself is not ugly, 
"I can't bear to look at it, the very thought of it, 
makes me feel sick. ' ' Without any participation 
on the part of the mental functions, unavoidable 
nausea may come on from irregular movement, 
as that of a ship, which often cause nausea to those 
unaccustomed to the sea. 

Certain conditions of the blood flowing through 
the nerve centers also causes nausea, as when 
emetics are injected into the blood. Giddiness, 
which consists of feeling of inability to keep the 
normal balance, is often produced in connection 
with the last by irregular movements, but more 
surely by a rotatory motion of the body. Other 
afferent influences may give rise to it, namely: 
from the stomach in some cases of irritation, from 
the eye, when we look from a height, from the semi- 
circular canals of the ear, by rotation of the body, 
and also from conditions of the blood as in alcoholic 
Toxemia. 

Shivering is the result of peculiar nervous affects 
produced by afferent influences, of an unpleasant 



2 26 CARE) OF THE BODY IN HEAI/fH AND DISEASE. 

kind. The sudden application of cold to the skin, 
a revolting sight, a shrill noise or an intensely nasty 
taste, all excite a nervous condition, which makes 
us shiver. 

Titillation follows light stimulation of certain 
parts of the cutaneous surfaces. It is a peculiar 
general sensation in moderation not disagreeable, 
and usually accompanied by a tendency to meaning- 
less laughter and other reflex movements. 



THE SENSE OF TASTE. 227 



CHAPTER XVI. 



THE SENSE OF TASTE. 



One of the more important of the senses, is that 
of taste, and is peculiar to the tongue. The point, 
sides and posterior part of the dorsum of the tongue 
can appreciate tastes; also parts of the palate have 
the power of taste, but in a much less degree than 
that of the tongue, though the palate is often spoken 
of as the seat of the taste. It really has but a 
small share of this function compared with the 
tongue. 

The power of being stimulated by various tastes 
is not restricted to the terminals of any one nerve, 
but is shared by some of those of at least three 
trunks, which also transmits impulses from other 
forms of stimulation. The Gloso-phyringeal divis- 
ion of the eighth pair of nerves sends branches to 
the posterior part of the tongue, which are no doubt 
connected with the special taste organs. The 
branch sent to the tongue of the fifth nerve, usually 
called the Gustatory nerve have also terminals 
capable of being excited by taste, and likely some 
fibers of the Chordo-tympani are employed in this 
function in the furrows around the circum- vallate 
Papillae and also though more sparsely on the sides 
of the Fungiform Papillae of the tongue are found 
peculiar organs called taste buds. They are flasked 
shaped bodies, arranged like the staves of a barrel 



22 8 CARE OF THE BODY IN HEALTH AND DISEASE. 

pinched together at the base, and at the free 
surface. 

These bodies consist of bars, supposed to be the 
nerve terminals. Under the microscope the whole 
arrangement reminds one some what like the head 
of Artichoke. Nerves are seen to enter these bodies. 

The relation of the Gloso-phyringeal nerves to 
these Tastes Buds has been shown by the fact that 
in the rabbit, in which animal, they are crowded 
together in a special organ so as to be easily found. 
They degenerate and in a few months disappear 
after one of these nerves have been cut. The 
genuine taste sensations are very few. Much of 
what we commonly call taste depends upon the 
smell of the substance, and we from habit confuse 
the impressions that arise from these two sensa- 
tions. The different tastes have been divided 
into four, that is; sweet, sour, bitter and salty. 
Under some of these headings all our tastes natur- 
ally fall; although this classification has no claim 
to be called a chemical one, it is interesting to know, 
that each taste pretty closely corresponds to a 
distinct group of substances, that are chemically 
closely related, -thus acids are sour, alkaloids are 
bitter. The soluble neutral salts of the alkalies 
are salty, and what are called the polyatomic alco- 
hols, as glycerine, grape sugar, etc., are sweet 
to the taste. These substances likely act on the 
nerve terminals, as chemical stimuli, because they 
must be in solution before they can be appreciated. 
If solid particles be introduced into the n outh, 
they must be dissolved before the tongue can ap- 
preciate the taste. 

In order to appreciate the different tastes, we 



the sense of smexiv. 229 

may imagine that there are different kinds of nerve 
terminals in the tongue, each of which is or is not 
influenced by the various substances possessing 
taste, such as sweet, sour, bitter or salty. From 
these different terminals nerve fibers pass bearing 
impulses to certain central nerve cells, each of 
which is capable of exciting a sweet, sour, bitter 
or salty sensation, as the case may be. 

THE SENSE) OF SMEUv. 

The Olfactory Nerve, which is the nerve of smell, 
on entering the nose, breaks up into an exceedingly 
delicate nervous tuft. When certain particles, 
to which we apply the term odors come in contact 
with these little terminals, they excite impulses, 
which when carried to the special centers of the 
brain, they give rise to impressions of smell. The 
odorous particles have to be in the form of gases 
or otherwise so finely divided that they may float 
about in the air, and the air must be kept in motion 
in order to excite the nerve terminals, which do 
not appear to produce odors unless the air is in 
motion, though they come in contact with the 
nerve terminals of the Olfactory. The extreme 
delicacy of appreciation of odors by the Olfactory 
Nerve terminals, is certainly very remarkable; 
even in human beings, whose sense of smell is very 
poorly developed, compared with some of the lower 
animals and amount of odorous substance can be 
perceived, which the finest chemical tests fail to 
appreciate. Some physiologists have estimated 
that the two-millionth part of a milligram of musk 
is sufficient to excite the special energy of a man's 
Olfactory apparatus. No satisfactory classifica- 



23O CARE Off THE BODY IN HEAI/fH AND DISEASE. 

tion of odors has been made out. The common 
division into agreeable and disagreeable smells or 
scents is dissimilar in different individuals, and 
therefore cannot have a physiological basis. 

With smell, as with taste, no degree of intensity 
of stimulation can be said to produce pain, though 
disgust, nausea, vomiting and many other nervous 
operations, are sometimes induced by smells. The 
appetite is either excited or annulled by odors. 

THE SENSE OF VISION. 

One of the most beautiful ways, that we are 
brought in relation with the surrounding world is 
by that of vision; the organ of which is the eye, 
and it is very remarkable what a great field of vis- 
ion we possess, when we only get a small beam of 
light, through a little aperture in the iris of the eye, 
ordinarily not bigger than a bird-shot, called the 
pupil, or sight of eye. When we look up at night, 
when the sky is clear and see hundred or thousands 
of stars, many of which are much larger than the 
earth, on which we live, and they are hundreds of 
millions of miles and even hundreds of billions of 
miles and yet we can see them, we cannot but 
come to the conclusion, that the range of our vision 
is very great. The eye of all vertebrate animals, 
including man, is enclosed in a firm case, which is 
called the schlerotic coat of the eye. It is seen 
between the eyelids, under the transparent con- 
junctiva, and is known as the white of the eye. 
It gives shape and protection to the eye, and though 
it is translucent, it is not transparent. In the 
front part of this Tunic, is a round window-like 



THE SENSE OF VISION. 231 

portion, which is called the Cornea, sometimes 
called the transparent Cornea, and forms the ante- 
rior segment of this protecting covering of the eye- 
ball, and is inserted into the Chlerotic coat with a 
beveled edge. - 

The Cornea is distinguished from the Schlerotic 
coat, not only by its glass like transparency, but 
also by being a part of a lesser sphere, than the 
Schlerotic and thus projects a little more than the 
rest of the globe of the eye. Closely attached to 
the inside surface of the Schlerotic is a thin black 
sheet of tissue called the Choroid coat. This, the 
Choroid coat carries the blood vessels, which supply 
the eyeball with blood. Its outer layer is traversed 
by Arteries and Veins of relatively large size, and 
its inner layers is composed a dense net-work of 
Capillary Vessels. As the Choroid coat comes 
forward, and approaches the Cornea, it is peculiarly 
modified and thrown into folds. These folds are 
called ciliary processes, forming a series of vascular 
folds, which radiate from the margin of the Cornea. 

At the edge of the Cornea, the Choroid is firmly 
attached to the Schlerotic by a very delicate little 
muscle, called the Ciliary Muscle, and also by bands 
of tissue from the posterior surface of the Cornea, 
which holds it in position. In a modified form, 
which is known as the Iris, this pigmented coat of 
the eye leaves the Schlerotic, and hangs freely in a 
fluid, being easily recognized through the clear 
Cornea, as a colored circular curtain. It is this 
pigmented curtain that is the colored part of the 
eye, which we speak of as black, dark, hazel and 
blue eyes. This curtain has a central opening in 
it which looks black, and as before stated is called 



232 CARE OF THE BODY IN HEALTH AND DISEASE. 

the pupil. The pupil is merely an opening in the 
Iris, which allows the ray of light to pass into the 
interior of the eyeball, besides serving as a medium 
for the transmission of vessels, to the globe of the 
eye, the Choroid is useful in vision by preventing 
the reflection of light from the back ground of tha 
eye, in such a way as would cause the irregularity 
of the distribution, and thus dazzle and interfere 
with the distinctness of vision ; in other words it is 
said to serve the purpose of absorbing the super- 
fluous rays of light. The Iris has a special power 
of motion by means of which the opening can be 
made smaller so as to regulate the amount of light 
admitted to the eye, and to cut off the rays of light, 
which would pass through the margin of the Diop- 
tic media. 

The importance of this will be better understood 
as we go further along. On the inner side of the 
Choroid, and immediately in contact with it, is 
the nervous coat of the eye, called the Retina. 
This is formed by the expansion of the optic nerve, 
which comes forward to the Schlerotic obliquely, 
and enters somewhat to the nasal side of the axis 
of the eye. This nervous coat, called the Retina 
lines all the back part of the eyeball, and comes 
forward to be fused with the ciliary processes. 

The Fibrils of the Optic nerve reach the inner 
surface of the coats of the eye, and lie in immediate 
relation to the transparent medium, which is called 
the vitreous humor, which occupies the greater 
part of the globe of the eye. The ultimate nerve 
endings are situated in pigmented cells, which 
forms the outer layer of the Retina. 



THE SENSE OF VISION. 233 

THE DIOPTRIC MEDIA OF THE EYEBALL. 

By Dioptric media of the eyeball, is meant the 
transparent parts of the eye, which light has to 
pass through to fall on the Retina, or be focussed 
on the Retina in order to produce vision. The 
transparent Cornea, the Aqueous humor, the Chrys- 
taline lens and its capsule and the vitreous humor 
constitute the Dioptric media of the eye. 

The Cornea has already been described which 
stands in the front part of the eye, next is the Aque- 
ous humor, which occupies from the Cornea to the 
Chrystaline lens, and next is the Chrystaline lens, 
and then the Vitreous humor, which occupies the 
chief part of the globe of the eye. These media 
act upon light, as all transparent bodies do, this 
action upon light is to bend the rays, and is called 
refraction. Light, when passing from a rare to a 
denser medium is refracted. The index of refrac- 
tion varies in different transparent bodies, each 
substance has an index of refraction of its own. 
Light is most strongly refracted by diamond, of 
all perfectly transparent bodies. Now, light in 
passing into the eye is refracted, first by the Cornea, 
which converges parallel rays or divergent rays, 
but this refraction is by no means sufficient to 
focus the rays on the Retina. 

The Chrystaline lens lies just at the back of the 
pupil, and is much harder than the Vitreous humor, 
but its outer layers are not much harder than jelly. 
It is perfectly transparent, and is nearly spherical 
in a child in shape, but becomes less convex with age. 

Now, in a transparent body, the rays of light 
are bent toward the thicker part, this Chrystaline 



234 CARE OF THE BODY IN HEALTH AND DISEASE. 

lens is a double convex lens, or in other words, it 
approaches a roundness, which makes it thicker 
in the center than elsewhere. Now, when the 
rays of light strikes the Chrystaline lens, they are 
all refracted except the central ones, that is: they 
are all bent toward each other, and in the healthy 
eye, which is called an Immetropic eye, they focus 
exactly on the Retina at a point called the Macula 
Lutea. Now, these rays are so refracted or bent 
by the Chrystaline lens, that the image on the 
Retina is inverted, in other words before the rays 
of light reach the Retina, they cross each other to 
form an inverted image. An ordinary double 
convex lens, made of glass will produce the same 
affect, that is : so bend the rays, that they will cross 
each other. If we hold a bi-convex lens a certain 
distance from the eye, and look out of the window 
we can see an inverted image of a landscape. If 
we now place a piece of transparent paper behind 
the lens, we can throw a representation of the pic- 
ture on it, which will be inverted, this power of 
convex lenses is employed in the instruments used 
for taking photographs, which consists of a box 
or chamber into which the light is allowed to pass 
through a convex lens so that an inverted image 
of the objects before it can be thrown upon a screen. 
When we wish to take a photograph, we substi- 
tute a sensitive plate, which may be sensitized by 
several different chemicals, such as Nitrate of Silver 
and Iodide of Potassium; a picture is formed by 
the uniting of the chemical principle of the light 
with the chemical, that is on the plate, and the 
image is inverted. The double-convex lens in 
the camera Obscura so bends the rays, that the 



THE SENSE OP VISION. 235 

image is inverted, in otherwords the rays cross 
each other; just in the same way an inverted image 
of the things we look at is formed on the Retina 
by the refracting media of the eye; though our 
organ of vision is often compared to a Camera 
Obscura, the refractions of light which occur in it, 
are far more complex than they are in the Camera. 
In the Camera we have only two media, that is : 
the glass lens and the air. In the eye, on the other 
hand, we have several, which have distinct refrac- 
tive influence on the rays of light, which pass 
through the pupil. 

THE ACCOMMODATION OF THE EYE. 

Respecting the accommodation of the eye, I will 
here quote from Yeo's Manual of Physiology the 
following : 

"As already stated, the normal eye is to be con- 
structed so that parallel rays of light, that is: those 
coming from practically infinite distance are brought 
to a focas on the Retina. This is why we see the 
stars, which are practically infinitely remote from 
us, as mere luminous points; it is therefore impos- 
sible to fix a far limit to our power of distant vision. 
The nearer an object is brought to our eyes, the 
more effort is required to see it distinctly, until 
at last a point is reached, where we cannot get a 
clear outline, no matter how we strain our eyes. 
For a normal eye, called the Immetropic eye, this 
near limit is about 12 centimeters, or five inches, 
but it varies in different individuals. For objects 
that are over ten meters distance, very little change 
in the eye is required to see each distinctly, and 
the nearer the object approaches the more frequently 



236 CARE) OF THE BODY IN HEALTH AND DISEASE. 

the adjustment of the eye has to be altered to see 
it clearly. 

When the eye is focussed for any point, within 
the limits of distinct vision, certain range of objects 
at different distances from the eye can be recognized 
without moving the adjustment. The range of 
this power is measured on the line of vision, and 
called focal depth. In the distance we can take 
in a great depth of landscape without effort or 
fatigue, but when looking at near objects, the focal 
depth is less, and we must constantly accommodate 
our eyes afresh in order to see clearly objects at 
slightly different distances, because of the shallow- 
ness of the focal depth in the near parts of visual 
distance. 

The method by which the accommodation of the 
eye is effected differs from anything that can be 
applied to an artificial optical instrument, and is 
more perfect. 

The following alteration are observed to occur 
in the eye during active accommodation, that is: 
when looking at near objects, first the Iris con- 
tracts so that the pupil becomes smaller, second 
central part of the anterior surface of the Chrystaline 
lens moves slightly forward, pushing before it the 
pupillary margin of the Iris, so that the lens be- 
comes more convex; third, the posterior surface 
of the lens also become more convex, owing to the 
general change of shape of the lens, but the center 
of this surface does not change its position. Fourth 
both eyes converge. These movements can be 
seen in life by observing the changes in relative 
positions and etc. of the reflection of a cannel flame 
thrown from the Cornea and the two surfaces of 



THE SENSE OF VISION. 237 

the lens. On the Cornea is seen a bright upright 
flame, next comes a large diffused reflection from 
the anterior surface of the lens, and at the other 
side of this, a small inverted image of the flame 
reflected from the posterior surface of the lens. 
When the adjustment is changed by looking from 
a far to a near object, the image on the front of the 
lens becomes smaller, and moves toward the center 
of the pupil. The image on the back of the lens 
also becomes smaller, but does not change its 
position. 

The amount of movement has been accurately 
measured by a special instrument called an Oph- 
thalmometer. The motions can be more exactly 
studied by means of the Phakoscope, a dark box, 
in which prisms are placed, before the observed 
eye, and each image is made double. The change 
in the relative position of the two is more readily 
recognized, than a mere change of size of the one. 
The alteration in the shape of the lens is accom- 
plished by the action of the muscular layer already 
named, which radiates from the edge of the Cornea 
to the Ciliary region of the Choroid coat, where 
it is attached. When the Ciliary muscle contracts, 
it draws the Choroid coat and the connections of 
the suspensory ligament of the lens, slightly for- 
ward, The junction of the Cornea, and the Schle- 
rotic being its fixed point. Under ordinary cir- 
cumstances, the eye being at rest, the suspensory 
ligament is tense, and exerts a radial traction on 
the anterior part of the capsule of the lens, tending 
to stretch it flat; this affects the shape of the soft 
lens, and reduces its convexity. When the Ciliary 
muscle shortens, it draws forward the attachment 



238 CARE OF THE BODY IN HEALTH AND DISEASE. 

of the suspensory ligament, relaxes it and removes 
the tension of the capsule, so that the unconstrained 
elastic lens bulges into its natural form. 

The posterior surface cannot extend backward, 
because there it is in contact with the vitreous 
humor, which is held more firmly against it by the 
increased tension of the Hyaloid membrane during 
the contraction of the Ciliary muscle. Some cir- 
cular muscular fibers help to relax the ligament, 
and relieve it from the increased pressure which 
the contraction of the radiating fibers must indirectly 
cause on the Vitreous humor. The act of accom- 
modation is a voluntary one, the nerve bearing 
the impulse to the Ciliary and the Iris muscles, 
coming from the third nerve by the Ciliary branches 
of the lenticular ganglion. The local application 
of the Alkaloid of the Belladonna Plan to atropin 
causes Paralysis of the Ciliary muscle, and wide 
dilutation of the pupil, and the Alkaloid of the 
Calabarbean, physostigman produces contraction 
of the muscles of accommodation and extreme 
contraction of the pupil. " 

THE DEFECTS OF ACCOMMODATION. 

Myopia, or near-sight is a condition of the eye, 
in which the rays of light focus in front of the Retina, 
and a blurred image is formed. It has been said 
that the near limit of distinct vision differs in many 
persons from the 12 centimeters of the normal 
emmetropic eye. The distance is about five inches 
from the eye, and it is found, that the power ac- 
commodation, varies very much in different in- 
dividuals, thus in near-sighted people, who have 
Myopic eyes, that is: eyes in which parallel rays 



THE SENSE OF VISION. 239 

of light are focussed in front of the Retina, the near 
limit may only be half the normal, that is, two or 
two and one-half inches, and the far limit, which 
is normally indefinite, is found to be in a compara- 
tively short distance of the eye. They, therefore 
cannot see distant objects clearly, since the rays 
are focussed before the Retina is reached, and 
then, diverging, cause diffusion circles, and blurred 
picture. The work of their condition is also much 
more laborious, since they can only see in that 
part of the range of accommodation, while the ad- 
justment has to be altered for slight variations of 
distance. This defect, if not of a very high degree 
can be remedied more or less by the use of concave 
lenses, which renders the rays of light divergent 
before they strike the Cornea, and thus allow the 
rays to focus on the Retina. 

Hyper-metropia is another defect in the accom- 
modation; it is sometimes called long-sight. In 
the Hyper-metropic eye, parallel rays of light are 
brought to a focus at a point beyond the Retina, 
so that divergent, or parallel rays cause diffusion 
circles, and a blurred image. This may be reme- 
died by means of convex lenses, which make the 
rays convergent before they strike the Cornea, 
and in this way enable them to be sooner brought 
to a focus by the dioptric media of the eye. 

Pres-byopia is a name given to change of the 
perfectness of accommodation, frequently accom- 
panying advancing years. The lens becomes less 
elastic and the Ciliary muscle weaker, so that the 
change in form required to see objects distinctly are 
difficult or impossible to attain. The lens being 
unable to render itself sufficiently convex, the focus 



240 CARE OF THE BODY IN HEALTH AND DISEASE. 

for near objects is beyond the Retina; convex 
lenses are the remedy. 

Another defect in our eyes is the condition called 
Astigmatism. This depends upon an irregular or 
imperfect curvature of the Cornea, which causes 
the rays to not all focus together. Some of them 
may be properly focussed, while the others are 
focussed in front of the Retina, or some of the rays 
may pass over the Retina. 

Slight degrees of astigmatism often pass unno- 
ticed, but the more decided forms of it require to 
be corrected by cylindrical lenses. 

MENTAL OPERATIONS OF VISION. 

Our visual sensations enables us to perceive the 
existence and correct form of various objects around 
us for visual perception, something more is neces- 
sary than the mere perfection of the dioptric media 
of the eye, and of the Retinal nerve mechanisms. 

Besides the changes produced in the Retina, 
and in the nerve cells of the visual center, there 
must be psychical action in all other cells of the 
cortex of the brain. This action of the brain con- 
sists of a series of conclusions, drawn by experi- 
ences gained by our visual and other sensations. 
Our ideas of objects are not always in exact accord 
with the image produced on the Retina and trans- 
mitted to the brain, but are the result of a kind of 
argument carried on, unconsciously in our minds, 
thus when no light reaches the Retina, we say that 
it is dark. Our Retina being stimulated, no im- 
pulse is communicated, and the sensation of black- 
ness arises in our sensorium. When luminous 
rays are reflected to the Retina, from various ob- 



THE SENSE OF VISION. 241 

jects around us, the Physiological impulse starts 
from the eye, but in the brain by unconscious 
psychical activity, it is referred in our minds to the 
objects around us, so that mentally we project into 
the outer world what really occurs in the eye ; so also 
from habit we reinvert in our minds the image, 
which is thrown upon the Retina up-side-down 
by the lens, and so unconscious are we of the psy- 
chical act, that we find it hard to believe that our 
eyes really receive the image of everything inverted, 
and our minds have to reinstate it to the upright 
position. 

One of the most important means employed to 
enable us to form accurate visual perceptions is 
the varied motion, which the eyeballs are capable 
of performing. 

BI-NOCULAR VISION. 

When we look at an object with both eyes, we 
have a separate image thrown upon each Retina, 
and therefore two sets of impulses are sent to the 
sensorium, one from each eye, yet we are only con- 
scious, or only can discern one image. It is said 
that the reason of this is, that experience has taught 
us that similar images thrown upon certain parts 
of the two Retinas, correspond to the same object, 
and in our minds, we fuse the sensations caused 
by the two images, so that they produce but one 
image. 

Bi-nocular vision is useful for the following pur- 
poses : 

FIRST to judge of distance; when using one 
eye only, some knowledge of distance may be gath- 
ered by the force employed to accommodate, but 



242 CARE OF THE BODY IN HEALTH AND DISEASE. 

a much more accurate judgment can be arrived at, 
when both eyes are used and the muscular sense 
of the ocular muscles, employed in converging 
the eyeballs for near objects, gives further evidence 
of their distance. 

SECOND in judging of size; in the same way 
with one eye we can only have an idea of the ap- 
parent size of an object, which will vary with its 
distance. With a knowledge of apparent size and 
distance, such as we gain by bi-nocular vision, we 
can come to a fairly accurate conclusion as to the 
size of an object. 

THIRD to be able to judge of the relative dis- 
tance of objects, such as to see depth in pictures, 
bi-nocular vision is necessary. If one eye alone 
is used, we see a flat picture, without having an 
accurate idea of the relative distances of different 
objects. With each eye, however we get a slightly 
different view of each object, and thus we are helped 
to a conclusion, as to their exact distances and shapes 
and arrive at correct judgments as to their form. 

THE SENSE OF HEARING AND SOUND. 

The sense of hearing and sound, being accurately 
described by Yeo in his Physiology, I will here 
quote from him the following: 

"Just as impulses, traveling along the Optic 
nerve, can only give rise in the sensorium to im- 
pressions of light, so in pulses passing into the sen- 
sorium via the auditory part of the Portio-mollis 
of the seventh pair of Cranial nerves can only ex- 
cite impressions of sound, and any stimulation of 
that nerve gives rise to sound sensations. The 
Peripheral end of the special nerve of hearing is 



THE SENSE OF HEARING AND SOUND. 243 

distributed to an organ of very peculiar construc- 
tion, situated in the internal ear, which from its 
complexity, has been called the Labyrinth. 

The nerve endings are spread out between layers 
of fluid, so that they must be stimulated by very 
gentle forms of movement, and when we consider 
their delicacy, we cannot be surprised, that even 
sound vibrations suffice to stimulate these terminals, 
and transmit nerve impulses to the brain. The 
Organs of hearing of the Mammalia are so deeply 
placed in the petrous part of the temporal bone, 
that special mechanisms have to be adopted to 
convey the sound with sufficient intensity from 
the air to the fine nerve terminals. These make 
up a complex piece of anatomy, which will be 
briefly referred to presently. 

Before attempting to describe the complex 
mechanisms, by which sound is conveyed from 
the air to the nerve endings, some notion must be 
formed of what sound is, from a merely physical 
stand-point. By means of the sense of hearing, 
we form an idea of sound, and here the knowledge 
of sound ends with many people, since they only 
think of it as something they can hear. A Phys- 
icist, however regards sound in a different way; 
he knows that it is produced by the vibrations of 
elastic bodies, such as a tense string, a metal rod 
or an elastic membrane. These vibrations being 
communicated to the air, are conveyed by it to our 
nerve endings where they are set up nerve impulses. 
The impulse is transmitted along the nerves of the 
brain, and there gives rise to the sensations, with 
which we are familiar, as sound. The vibrations 
of the air are wave-like movements depending 



244 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

upon a series of changes of density in the gases, 
the particles of which move toward or from one 
another, and transmit the motion to their neighbors, 
so as to propagate the sound wave. 

To demonstrate these vibrations, a special ap- 
paratus must be used. When a tuning fork is 
struck, it is thrown into vibrations and a sound is 
given forth, but the vibrations are often so rapid, 
and so small, that the motion of the tuning fork 
cannot be appreciated by the eye, but if a fine 
point be attached to one prong of the tuning fork, 
or indeed any elastic body, such as a bar of metal, 
and this point be brought into contact with a mov- 
ing smoke surface, such has been already described 
for similar records, a little wavy line is drawn, 
showing that the vibrating fork moves up and down 
at an even and regular rate. Each up and down 
stroke indicates a vibration. The length of the 
wave as drawn on an evenly moving surface of the 
recorder, shows the amount of time occupied by 
each vibration. This is always found to be the 
same for a tuning fork of a given pitch, and thus 
the recording fork is in constant use by the Phys- 
iologist, as an exact measure of small intervals of 
time. The pitch of the note depends upon the 
rate or period of vibration. A tone of a certain 
pitch being simply a sound caused by so many 
vibrations per second, the quicker the vibration 
the higher the note, and the slower the deeper, 
until at the rate of about thirty per second, no 
sound is audible. Whether a note be produced 
by a metal fork, a tense string, or any other vibra- 
ting body, if a number of vibrations per second 
be the same, the note must have the same pitch. 



THE SENSE OF HEARING AND SOUND. 245 

The elevation of each vibration, as seen in the 
tracing made by a recording fork, is different at 
different times. When the fork is first struck, 
-the waves are high and well marked. The excur- 
sions of the recording prong become less and less 
extensive. As the fork gradually ceases to vibrate, 
and the sound diminishes, or in other words, as the 
sound produced, becomes fainter, the vibrations 
become smaller. The amount of excursion made 
by the vibrating body is spoken of as the amplitude 
of the vibration, and upon it depends the loudness 
or intensity of the sound. The pitch of a tone 
bears no relation to the amplitude of the waves 
of the vibration, but depends upon their rate, 
while its loudness is quite independent of the period 
occupied by the vibrations, but is in proportion 
to the amplitude of the waves. 

So far, only tones or musical notes have been 
mentioned. They are produced by vibrations oc- 
curing at perfectly regular periods. The simple 
and more regular the vibrations, the fewer the tones 
The great majority of the sounds, we are accustomed 
to hear, are not pure tones, but are the result of an 
association of vibrations bearing some relation to 
one another; when the variety of vibrations is very 
great, their intervals irregular and out of propor- 
tion, they give rise to a discorded sound, called 
noise. So long as such commensurability exists 
in the rate of the vibrations, as to produce a sound 
not disagreeable to the sense of hearing, it may be 
called a note. 

By the use of a series of different Resonators, 
each of which is capable of magnifying a certain 
tone, it can be shown that the clearest and purest 



246 CARE OF THE BODY IN HEALTH AND DISEASE. 

notes, of our musical instruments are far from 
being simple tones, but are really compounds of 
one prominent note or fundamental tone, modified 
by the numerous additions of overtones or harmon- 
ies. If one blows forcibly across an orifice, leading 
to a space, in which a small amount of air is confined, 
such as the barrel of a key or the mouth of a short- 
necked flask or bottle, either a clear shrill or a dull 
booming sound is heard, which varies in pitch ac- 
cording to the proportions of the air containing 
cavity. This dull note is a simple tone. It is 
devoid of character, and in this respect differs 
greatly from the notes produced by a musical in- 
strument. 

The notes of every instrument have certain 
characters, or qualities, which enables even an un- 
practiced ear to distinguish them. This quality, 
which is independent of the pitch, or the intensity 
is called the color or timber of the note. It depends 
on the number, variety and relative intensity of 
the overtones, or harmonics, which accompany 
the notes, so that really the timber, or quality of a 
note, and therefore the special characters of the 
different musical instruments is produced by their 
impurity or the complexity of the overtones, which 
aid in producing them. 

All elastic bodies can vibrate and therefore are 
capable of conducting sound. Sound vibrations 
may be transmitted from one body to another 
placed in contact with it. From a hard material 
the waves readily communicate with the air, and 
this is the ordinary medium by means of which 
sound is transmitted to our organs of hearing. In 
the old experiment of placing the small bell under 



THE SENSE OF HEARING AND SOUND. 247 

the glass of an air-pump, and making the tongue 
strike after the air has been removed, the fact that 
no sound is produced, shows that the medium fo 
the air is essential for the transmission of sound 
vibrations. The transmission of waves of sound 
from the air, more dense materials, such as those, 
which surround our Auditory nerve terminals 
takes place with much greater difficulty, than that 
from a solid to the air, and we find a variety of 
contrivances by which the general air waves, ar- 
riving at the ear are collected and intensified on 
their way to the labryinth. 

The medium of the air is not necessary in order 
that its sound may reach the internal ear, nor is 
the route through the outer canal, and the drum 
and its membranes, is the only one by which the 
vibrations can arrive at the Cochlea. 

The solid bone, which surrounds the Labyrinth, 
is in direct communication with all the bones of 
the head, and sound can travel along these bones 
and reach the nerve endings. This can easily be 
proved, by placing the handle of a vibrating tuning 
fork against forehead or better still against the 
incisor teeth. Sound, although previously hardly 
audible at once becomes quite distinct or even 
appears loud. This direct conduction through 
the bones of the head is under normal conditions 
of little use to man, but attempts have been made 
in cases where the ordinary auditory passages were 
rendered inefficient by disease together with the 
vibrations on an elastic plate and apply this to the 
teeth. 

This direct conduction of sound is very valuable 
in determining the seat of disease in cases of deaf- 



248 CARE OF THE BODY IN HEALTH AND DISEASE. 

ness. So long as the clear sensation of sound 
reaches the brain, through the bones of the head, 
we know that the important nerve endings, and 
their central connections are unimpaired, and 
conclude that the disease lies in the mechanical 
conducting part of the hearing organs. ' ' 

THE STIMULATION OF THE AUDITORY NERVE. 

The stimulation of the nerve of hearing by sound 
vibrations of the air is less difficult to understand 
than that of the Optic nerve by light waves, which 
are conveyed by an imponderable medium. The 
motions of the membrane of the drum being con- 
veyed in the manner already indicated to the liquids 
within the internal ear, pass over and under the 
cells connected with the nerve terminals, which 
are placed on the elastic vascular membrane, the 
basis of the inner rods being fixed at the inner mar- 
gin of the vascular membrane can move but little, 
and the basis of the outer rods being placed near 
the middle of the fibers of the membrane, where 
the motions of the vibrations are most extensive, 
a slight change in their relative positions and the 
consequent movement of bath take place. 

This movement of the apex of bow, where the 
rods join, is communicated by the medium of the 
reticular membrane to the ear, and the special 
Auditory cells, thence to the nerves where an ex- 
citation is produced, giving rise to the transmission 
of an impluse to the brain. We are first enabled 
to determine differences of loudness, and second 
of pitch, and third of qualities and sounds. Since 
the loudness depends simply on the amplitude 
of the vibration, we have no difficulty in under- 



6 



THE SENSE OF HEARING AND SOUND. 249 

standing how variations in it can be appreciated 
since the more ample the vibration, the more 
marked motion and therefore the more intense 
the stimulation of the nerve terminals. What 
we call the loudness of a sound, simply means a 
greater or less stimulation of the intensity of the 
nerve. The perception of the difference of pitch 
presents greater difficulty. As already mentioned, 
this depends upon the rate of vibration. We know 
that most bodies, capable of producing sound vi- 
brations have a proper tone, that is, that which 
they produce when struck. When the tone proper 
to a body, capable of vibrating, is sounded, in its 
immediate neighborhood, it also is set vibrating 
through the medium of the air. If a clear tone 
be sounded loudly, over the strings of a piano a 
kind of sympathetic echo will be heard to come 
from the strings, corresponding to the notes sounded. 

In the vascular membrane, we have practically 
a series of strings of different length. Since the 
membrane gets wider as it passes from below up- 
ward to the summit of the Cochlea, and therefore 
a great variety of proper tones. With a high note, 
a fiber of one part of the membrane will readily 
fall into vibration, and with a low note the fiber 
of another part. Different nerve fibers are in re- 
lation to these different parts, and we may conclude 
that tones of different pitch stimulate distinct 
nerve terminals, and are conveyed to the brain by 
separate nerve channels. Impulses arriving at 
certain brain cells give rise to the ideas of high 
tones, and the impression coming to others cause 
the impression of low tones. 

There are about a sufficient number of fibers in 



250 CARE OF THE BODY IN HEALTH AXD DISEASE. 

the vascular membrane for all the notes we can 
hear, that is, from about thirty-three to thirty- 
eight thousand waves in a second. The explana- 
tion of our wonderful appreciation of the delicate 
shades of quality of tone is still more difficult. 
Even persons with indifferently good ears, as mu- 
sicians say, and no special musical education can 
at once distinguish between the quality of the same 
note, when sounded of a violin, piano and a flute. 

When a note is sung against the strings of a piano, 
however pure its tone, a great number of strings 
are set vibrating. Xot only does the string of the 
note vibrate, but also those that have a certain 
numerical relation to its vibrations; in fact all its 
overtones resound. 

In the Cochlea, we suppose the same to take 
place with the fibers of the vascular membrane. 
Xot only does the one fiber, whose proper tone is 
sounded vibrate in response, but also those that 
represent the varied overtones or harmonics. 

It has already been indicated, that the quality 
of a tone depends on the relative number, force 
and arrangement of harmonics, which invariably 
accompany any musical note, that possesses a dif- 
ferent character. When a note arises at the Audi- 
tory nerve terminals, one of these is strongly stim- 
ulated by the wave of the fundamental tone, and 
many others by different overtones, for every 
prominent overtone stimulates the Cochlea. The 
complexity of the impression increases with the 
impurity of the tone, and so we appreciate the 
quality of a note, thus a compound of impulses, 
corresponding to a mixture of tones of varying 
intricacy is transmitted to the brain cells, where 



THE SENSE OF HEARING AND SOUND. 25 1 

it gives rise to the impression of the quality which 
we by experience associate with that of a violin, 
flute or piano, as the case may be. 

With regard to the judgment of the distance 
of sound, it may be said that it chiefly depends on 
former experience of the habitual quality and in- 
tensity of sound. 

A faint sound with the same quality, that we 
familiarly attribute to a loud sound, seems to us 
to be far away, thus sounds, reaching our Laby- 
rinth by the cranial bones, appear distant, and 
ventriloquists deceive us by imitating the charac- 
ter of distant sounds. The direction from which 
sound comes is chiefly judged by the difference of 
intensity, with which it is heard by one or the other 
ear? When we cannot form any idea of what 
direction a sound comes, we turn our heads one way 
or the other in order to present one ear more directly 
to the origin of the sound. 

When a sound is either directly behind or before 
us, we cannot judge from which position it really 
comes, unless the head be turned slightly to one 
side or the other before the vibrations have ceased 
to be Audible. 

THE MECHANISM AND USES OF RESPIRATION. 

In the lower forms of animal life, breathing is 
not required, such animals as live in the water and 
in the ground, do not require but little oxygen. 
They absorb all their necessary oxygen from water ; 
some of them are provided for gills for this purpose. 
They are always cold-blooded, and consequently 
combustion in them is very feeble, but in the higher 
organizations of animal life, combustion is carried 



252 CARE OF THE BODY IN HEALTH AND DISEASE. 

on in a much more energetic way, and the animals 
are warm-blooded, and are provided with lungs. 
These lungs are constructed in such a way, that 
the blood of the animal is brought in contact with 
the air so closely that it readily absorbs the oxygen, 
and can equally as readily dispose of the Carbon 
dioxide. This gas interchange takes place at birth, 
and is carried on continuously to the end of their 
lives. 

Before birth the mother breathes for her child; 
the construction of the Placenta is such as to readily 
take the oxygen from the mother, otherwise the 
child would immediately die. As has already been 
stated in a previous chapter, the air consists of 
Oxygen and Nitrogen, and some other normal 
constituents, that are not necessary to the present 
discussion. About twenty one per cent, of the air 
is Oxygen in the form of a gas. This gas is abso- 
lutely essential to all forms of animal life, and in 
the higher animals, as man it carries on a burning 
process, that keeps the temperature of the blood 
up to one hundred degrees, Fahrenheit Therm- 
eter. The Carbon of the tissues furnish the fuel, 
and the oxygen unites with the Carbon of the tis- 
sues in the same way, that it does the carbon of 
coal or wood in a fire, and the product is the same, 
which is Carbon-dioxide, but in animal life there 
is a regulating mechanism, that keeps the tempera- 
ture very much below that of flame. 

The regular income of Oxygen and the discharge 
of the Carbon-dioxide as the first essentials to life; 
here as in nutrative materials, the blood acts as a 
carrier, the Pulmonary half of the circulation is 
completely devoted to this gas interchange between 



RESPIRATION. 253 

the blood and the atmosphere. The gas inter- 
change between the blood, and the tissues takes place 
in the Systemic Capillaries, and is sometimes called 
the Tissue Respiration. In all the Mammalia, 
the Pulmonary Apparatus is so far perfected that 
all the gas interchange, that is necessary can be 
carried on by the lungs, and the respiratory influ- 
ence of the skin or the mucus membranes may be 
regarded as insignificant, but it should be remem- 
bered that whenever the blood is in close relation 
to the Oxygen, the Oxygen is readily absorbed by 
the blood, and in some of the lower animals, the 
surface of the skin aids materially in respiration. 
Frogs can live by this skin respiration for almost 
an indefinite time. 

As has already been indicated, the change in the 
lungs consists in the Oxygen being taken from the 
atmosphere by the blood, and Carbon-dioxide being 
given off from the blood to the air. In the Capil- 
laries of the tissues on the other hand, the blood 
takes up the Carbon-dioxide, and gives over the 
chief part of the Oxygen that it contains. When 
the blood receives the Oxygen in the lungs, it changes 
its color from a maroon or slightly bluish color to 
that of a scarlet red. 

The lung consists of an almost infinite number 
of minute air sacs, that are all the time more or 
less filled with air. These little air sacs are called 
Alveoli. The channels, that enter to and from 
these sacs are called the air passages, and the motor 
arrangements, that carry on the ventilation of the 
lungs are usually spoken of as the chest. 

As stated in a previous chapter, the Pulmonary 
Artery when entering the lung, bursts up into an 



2 54 CARE OF THE BODY IN HEALTH AND DISEASE. 

innumerable number of Capillaries. Now, each one 
of these little sacs, that has just been spoken of is 
supplied with one the Capillaries. The wall be- 
tween the sac and the Capillaries is so constructed 
that when in health, no blood whatever can escape 
into the sac, yet the Oxygen, which is in the form 
of a gas can instantly pass through the wall into 
the blood, and conversely, the Carbon-dioxide, 
and other waste products can escape into the air 
of these little sacs with facility. 

The lungs are completely invested by a fine deli- 
cate membrane belonging to the serous variety, 
and on either side is reflected off on the wall of the 
chest, so that when the lungs on either side is pressed 
aside, there is a serous sac often spoken of as the 
Pleural cavity. The air passages are kept perman- 
ently open during ordinary breathing by the elas- 
ticity of their tissues. 

The Trachea and the Bronchi have special car- 
tilaginous springs for the purpose. These are 
closely attached to the elastic tissues, which com- 
plete the general foundation with the walls of the 
tubes. From a mechanical point of view, the 
Thorax may be regarded as a specially arranged 
bellows, whose dimensions can be increased in all 
directions, Within this bellows, the lungs are 
situated which may be regarded as an elastic bag, 
the interior of which communicates with the outer 
air by an air pipe, this being the only way by which 
the interior of the lungs can receive the air. 

When the frame work enlarges, the pressure of 
the atmosphere forces a stream of air into the elas- 
tic sac so as to distend it, and thus fill the space 
caused by the expansion. By the motions of this 



RESPIRATION. 255 

frame work, the stream of air passes in and out of 
the lungs, and a small quantity of the air is in this 
way changed at each breath, and a certain standard 
of purity attained. 

In order to fully understand all the accessory 
motions, by which breathing is carried on, a very 
much better knowledge of anatomy of the chest 
and its muscles, than I have space to give in this 
place is required. The motions are divided into 
two sets: Those which enlarge the cavity, and 
cause the air to rush into the lungs, is called inspir- 
ation, and those which diminish the size of the 
cavity and force out the air is called expiration. 

There is no action of life, which is more familiar 
to everyone than the steady movements of respira- 
tion. The slow quiet rise and fall of the chest and 
abdomen are the signs most commonly looked 
for, as indicating existing life, for everyone knows 
that constant ventilation must go on in the lungs 
in order that the blood may readily obtain the re- 
quired amount of Oxygen, and get rid of its end 
product, that is, Carbon-dioxide. 

The rate of the respiratory movements is up to 
a certain point under voluntary control, and can 
be varied by the will, or even stopped for a short 
time, as when one holds his breath. This control 
of the respiratory movements is at any rate very 
limited, for if we hold our breath for any length 
of time, a moment soon arrives when the necessity 
of respiration overcomes the strongest will. The 
usual respiratory movements are carried on with- 
out our being conscious of them, and are strictly 
involuntary. The rate of the respiratory move- 
ment varies according to the circumstances, being 



256 CARE OF THE BODY IN HEALTH AND DISEASE 

in an adult man about 18 per minute. In most 
of the lower animals, it is more rapid. It varies 
with the age, being very rapid at birth, decreasing 
slowly till about thirty years, and slightly rises in 
old age. 

Muscular exercise increases the rapidity of the 
respiratory movements and the effort of standing 
produces a more frequent respiration, than is found 
in the recumbent posture. 

Emotions very easily affect the rate, and rhythm 
of inspiration and expiration, and finally diseased 
conditions, especially those of the lungs, for the 
most part cause a frequency of respiration. Some- 
times going as high as sixty or seventy respirations 
per minute. 

The Thorax is enlarged in all directions during 
inspiration. The vertical diameters increase dur- 
ing inspiration by the descent of the latter portion 
of the diaphragm, and by slight elevation of the 
parts about the apex of the lungs, the movements 
of the diaphragm depress the abdominal viscera, 
and thereby distend the abdominal wall, thus the 
movements of the diaphragm cause a rhythmical 
heaving of the abdomen. Respiration, depending 
chiefly on the action of this one muscle, is therefore 
spoken of as Abdominal Respiration; on the other 
hand when the ribs are the chief cause of the ex- 
tension, it is called Thoracic Respiration. Anyone 
can imitate these respiratory movements volun- 
tarily. These two forms of respiration are variously 
combined in different individuals. 

In men, the general character of the ordinary 
required respiration is abdominal, the movement 
of the Thorax being insignificant, as compared 



RESPIRATION. 257 

with the abdomen. In women, the reverse is the 
case. The abdominal movements are slight, when 
compared with the movement of those in the upper 
part of the Thorax. This difference is only well 
marked during quiet unconscious breathing. Any 
forced or voluntary respiratory effort, changes 
the character of man's breathing, and the costal 
movements become more prominent. In a forced 
deep inspiration, the upper part of the chest, shows 
the greatest increase in the antero-posterior diam- 
eter in both sexes. This difference in type between 
male and female respiratory movements have been 
assigned to different causes. It has been urged 
that this change is brought about by the costume, 
ordinarily adopted by females. 

This can hardly be a sufficient explanation; we 
find the same type existing, when the tight garments 
are removed, and its apparent in those, w r ho have 
never been constricted by tight clothing, and even 
in those, who wear no clothing, as among some 
barberous tribes of hot countries. So that the 
corset may induce an exaggeration of the costal 
or Thoracic respiration by constricting the lower 
ribs and interfering with the action of the Diaphragm 
but it does not seem sufficient to account for the 
normal Thoracic type of breathing found in women. 

The occasion of the distension of the abdomen 
during pregnancy has also been assigned as a cause 
of the female type of breathing, but it is very un- 
likely that pregnancy is the sole agency in the pro- 
ducing of it. Since the Thoracic type of breathing 
is sufficiently well marked in the female child, that 
this type of breathing should be transmitted to 
females from their ancestors is the most plausible 



258 CARE OF THE BODY IN HEALTH AND DISEASE. 

explanation. On the other hand the abdominal 
breathing of the male is also increased by heredie- 
tary transmission, but is also said to be due to the 
gradual increase in development of the muscles 
of the upper extremities. During quiet breathing, 
expiration requires no muscular effort. 

Expelling of the air from the chest is accomplished 
by the elasticity of the parts. A powerful expir- 
atory force in the elasticity of the lungs, which 
are on the stretch even after a forced expiration. 
The ordinary shape of the elastic walls of the chest 
corresponds with the position at the end of gentle 
expiration, for that reason the resiliency of the 
muscles and cartilages of the ribs, as well as other 
elastic tissues, which are stretched during inspira- 
tion, tends to restore the ribs to the position of 
expiration. 

After death when the elasticity of the expiratory 
muscles is lost, the traction exerted by the lungs 
on the Thorax reduces it below the size its own 
elastic equalibrium would tend to assume. When, 
therefore air is admitted to the Pleural cavity by 
puncture, the Thorax slightly expands, and the 
lungs shrink. The pressure on the Pleural surface 
becomes equal to the pressure in the Bronchial 
tubes. 

During respiration the volume of inspiratory 
and expiratory stream of air is quite small in com- 
parison with the volume of the air sojourning in 
the lungs. After an ordinary expiratory motion, 
one can force out a great quantity of air by volun- 
tary effort, but even after this is gotten rid of there 
is a considerable amount of air in the lungs. This 
air is called the residual air. Some of this residual 



RESPIRATION. 259 

air, which never leaves the chest, during the life 
of the animal, is pressed out by the elasticity of 
the lungs, when the Peura is opened, but a certain 
amount of air cannot be removed from the lungs 
by any process. 

In order to have a clear idea of the volumes of 
air at rest and in motion, during the ventilation of 
the lungs, it is convenient to follow the classifica- 
tion from which the nomenclature in common use 
has been taken. Tidal air, is the current of air, 
which passes in and out of the air passages in quiet 
natural breathing. It amounts to about 30 cubic 
inches in the adult, but varies considerably, being 
sometimes above this and sometimes below it. 

Reserve air, is the air, which can be forced out 
of the lungs after the Tidal Air is out, and of course, 
ordinarily remains in the lungs; this too varies in 
quantity, but in the adult approximates one hun- 
dred cubic inches. 

Complemental air, is the air, that can be forced 
into the lungs after an ordinary inspiration. It, 
too approximates about one hundred cubic inches 
in the adult. 

Residual air, is the volume, which remain in the 
lungs after a forced expiration, and as before stated, 
can't be gotten rid of during life. In the adult it 
averages about one hundred and twenty cubic 
inches. 

The vital capacity, is a term, that means the 
greatest amount of air, that can be forced out 
the lungs following a forced inspiration, so that 
it equals the Tidal reserved and Complemental 
Air. In the true sense of the term, it is often diffi- 
cult to estimate the vital capacity, It is estimated 



260 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

by the capacity of the chest, the power of the re- 
spiratory muscles, the resistance offered by the 
elasticity or rigidity of the walls of the thorax, 
the working capacity of the lungs, their extensi- 
bility and freedom from disease, it therefore varies 
greatly according to the age, sex, position of the 
body, the occupation, weight, height, the fullness 
of the hollow viscera of the abdomen, and the 
pathological condition of the lungs. It can be 
very much increased by practice, and this fact 
aside from the injury, that forced respirations 
may produce in the diseased state of the lungs, 
renders it unsuitable, as a gauge in diseases of those 
organs. 

From what has been stated, it appears that the 
volume of air, sojourning in the lungs, during nat- 
ural breathing, would approximate 220 cubic inches 
in the adult, while the fresh air introduced at each 
breath only amounts to about thirty cubic inches, 
or in otherwords, about one seventh of the air of 
the lungs is changed at each breath. As the stream 
of air enter the passages, that lead into the lungs, 
they produce sounds, which are of very great im- 
portance to the Physician, owing to the manner in 
which their character may be changed by disease. 
A sound called Bronchial breathing is produced 
in the large Bronchial tubes and Trachea, and is 
like the noise of the air blowing through a tube. 
This can be heard over the Trachea or at the back 
between the shoulder blade or at the entrance of 
the large tubes into the substance of the lungs. 
Another sound, that is called Vessicular can be 
heard in healthy individ. als all over the chest. 
With the exception of the uncovered part of the 



RESPIRATION. 261 

Heart by lung. This sound is most distinct where 
the lung is most superficial, as in the subaxillary 
region. It is a gentle rustling sound, caused by 
the air passing into the air cells. It varies much 
with the force of the respiration, and many other 
circumstances. In children up to 10 or 12 years 
of age, it is sharper and louder than in the adult. 

MODIFIED MOVEMENT OF THE RESPIRATORY 
MUSCLES. 

Besides the ordinary respiratory motions, and 
the voluntary modifications made use of in speak- 
ing and singing, the muscles of respiration perform 
a series of movements of an involuntary reflex 
nature, which are indications of certain motions 
and mental states. 

The following are the more important: 

Coughing is caused by an offensive irritating 
substance, which may be located in any part of 
air passages. It consists of a deep inspiration 
and closure of the Glottis, and then a more or less 
violent or expiratory effort accompanied by two, 
three more or less sudden openings and closures of 
the Glottis, so that rapidly repeated blasts of air 
pass through the upper air-passages and the mouth, 
which is generally held open. 

Sneezing is caused by a stimulant applied to 
the nose or eyes, the impulses being carried to the 
respiratory center, by the nasal or other branches 
of the fifth nerve. It consists of a deep inspira- 
tion and closure of the Glottis followed by a single 
explosive expiration and sudden opening of the 
Glottis, with some facial distortion. Sneezing is 
purely a reflex act, since it cannot be produced 



262 CARE OF THE BODY IN HEALTH AND DISEASE. 

voluntarily, other than by the stimulation of the 
nasal mucus membrane. 

laughing consists of a full inspiration followed 
by a long series of very short rapid expiratory 
efforts. 

The facial muscles are at the same time thrown 
into a characteristic set of movements. 

Crying is made up of a series of short sudden 
expirations with peculiar contortions of the face, 
and with shedding of tears often associated with 
sobbing. 

Sobbing consists of a rapid series of convulsive 
inspiratory efforts, which allows but little air to 
inter the chest. 

Sighing is a long slow inspiration, quickly fol- 
lowed by a corresponding expiration. 

Yawning is a very long deep inspiration, com- 
pletely filling the chest. It is usually accompanied 
by a peculiar depression of the lower jaw, with a 
wide open mouth and a stretching of the limbs. 

Hiccough is an unexpected inspiratory spasm, 
chiefly of the Diaphragm, the entrance of the air 
being checked by the sudden closure of the Glottis. 



VOICE AND SPEECH. 263 



CHAPTER XVII. 

VOICE AND SPEECH. 

The human voice is produced by blasts of air 
being forced through the narrow opening at the 
top of the wind -pipe, called the Glottis. 

The Glottis, which lies in the lower part of the 
Larynx is bounded on each side by elastic mem- 
branous folds, that project into the air passages. 
These folds are called the Vocal Chords, and are 
set vibrating by a current of air from the lungs, 
and in turn they communicate vibrations to the 
air, situated above them. 

As the human voice is so very important a fac- 
ulty, not only in the transactions of all forms of 
business, but that a cultivated voice is much more 
pleasant than a harsh disagreeable one, and as the 
voice admits of very extensive cultivation, I will 
here give a sketch of the anatomy of the parts 
concerned in voice. 

The vocal apparatus produces sound in the same 
manner, as a musical wind instrument. If we 
compare it with the pipe of an organ, we shall find 
all the parts of the latter represented. The lungs 
within the moving thorax, act as a bellows. The 
bronchial tubes and the trachea are the supply 
pipes and the air-box, the vocal chords are the 
vibrating tongues, while the larynx, pharynx, 
mouth and nose act as the accessory or resonating 
pipe. The tongue assists in pronunciation and 



264 CARE OF THE BODY IN HEALTH AND DISEASE. 

casting sounds into words. The blast of air is 
regulated by the respiratory muscles, and special 
intrinsic muscles of the larynx change the condi- 
tion of the vocal chords, so as to alter the pitch of 
the notes produced; other sets of muscles by alter- 
ing the conditions of the resonating pipes, give 
rise to the many modifications in the vocal tones, 
and thus produce what is called speech. 

The larynx, which may be regarded as the spec- 
ial organ of the voice is made up of four cartilages, 
the cricoid, thyroid and the two arytenoids, joined 
together so as to allow considerable motion; of 
these, the inferior or lower one is the cricoid. It 
is attached to the trachea which it joins to the 
others. It forms a ring, which is thin in front, 
but deep and thick behind, owing to a peculiar 
projection upward of its posterior part. 

The thyroid consists of two side wings, so bent 
as to form the greater part of the anterior and 
lateral boundaries of the voice box and each wing 
can easily be felt in the front of the throat. 

The arytenoid cartilages are little three-sided 
pyramids placed on the upper surface of the back 
part of the cricoid cartilage, and are attached to 
the latter by a loose joint. They are so placed, 
that one surface looks inward, and the third for- 
ward, while the inferior surface rides on the cricoid. 
One point looks forward, and to it is attached the 
vocal chord on each side, and has been called the 
vocal process. The apex, which looks outward 
and backward gives attachment to some of the 
intrinsic muscles and has been called the muscular 
process 

The thyroid cartilage is connected with the Cri- 



VOICE AND SPEECH. 265 

coid below and with the hyoid bone above by liga- 
ments and tough membranes, which hold the parts 
together, fill in the intervals and complete the 
skeleton of the larynx. 

The vocal chords are composed of small strans 
of elastic tissue, which pass from the anterior sur- 
face of the arytenoid cartilages to the inferior part 
of the thyroid, to which they are inserted. 

The mucus membrane, which lines the larynx 
is thin, and closely adherent over the vocal chords. 
The surface of the laryngeal cavity is smooth and 
even, the lining membrane passing over the car- 
tilages and muscles, so as to obliterate all ridges, 
except the vocal chords and a few others which 
are less sharply defined and are called the false vocal 
chords, which lie parallel to and above the true 
vibrating chords. 

Taking the thyroid cartilage as a fixed base, 
the cricoid and the arytenoid undergo movements, 
which bring about two distinct sets of changes in 
the glottis and its elastic edges. First, widening 
and narrowing the opening, Second, stretching and 
relaxing of the vocal chords. 

During ordinary respiration, the glottis remains 
about half open; during a forced inspiration, the 
glottis is widely dilated. If an irritating gas be 
inspired, the glottis is closed by a spasmodic action 
of certain muscles, so that the true vocal chords 
act something in the nature of a valve. 

During vocalization the glottis is formed into a 
narrow chink with parallel sides, while the chords 
are made more or less tense, according to the pitch 
of the note to be produced. All these movements 
are executed by muscular action, The opening 



266 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

of the chink of the glottis, is accomplished chiefly 
by a muscle called, the Posterior Crico Arytenoid, 
which passes from the posterior surface of the 
cricoid cartilage to the outer angles of the Aryte- 
noids on either side. By pulling the latter part 
downward and backward, it separates the aryte- 
noid cartilages, particularly at their anterior ex- 
tremity, where the chords are attached. In this 
action it aids by a small muscle, connecting the 
posterior surface of the arytenoid, which tend 
when the two arytenoid cartilages are held apart 
to rotate them so that the vocal processes are sep- 
arated. 

The glottis is narrowed by the lateral crico 
Arytenoids which pass upward and backward 
from the cricoid to the muscular processes of the 
arytenoid cartilages. They pull the muscular 
process forward, and thus rotate the arytenoid 
cartilages, so as to approximate the vocal processes 
toward one another. 

While any tendency toward pulling apart the 
bodies of the cartilages is over come by the Poste- 
rior-Arytenoid muscles, which are resisted by the 
bands of the muscles that pass from the back sur- 
face of the arytenoid cartilages to the epi-glottis, 
and the upper part of the Thyroid cartilage. The 
external-thyro-arytenoid and the thyro-ary-epi- 
glotic muscles. The upper fibers, which pass 
directly from the arytenoid to the thyroid carti- 
lages. The internal and external thyro-arytenoid 
muscle being in the same direction as the vocal 
chords, complete the closure by helping to press 
together the vocal processes, and by approximating 
the chords themselves. 



voice: and speech. 267 

In a spasmodic closure of the glottis, all these 
latter muscles act with violence together and are 
sometimes called the constrictors of the glottis. 

Relaxation of the vocal chords * accompanies 
the voluntary closure of the glottis, as in the hold- 
ing of one's breath, when the vocal chords are said 
to have a valvular action. 

The muscular fibers, which run from the Aryte- 
noid cartilages to the Thyroid, nearly parallel to 
the vocal chords are those concerned in the act of 
relaxation, when the chords are active, they pull 
forward the arytenoid cartilages, and at the same 
time draw- the upper part of the cricoid slightly 
forward. These muscles have all the important 
action of the adapting the edges of the chords in 
the neighboring surfaces to the exact shape, which 
is of most advantage in their vibration. The 
tightening of the vocal chords is caused by a single 
muscle, the crico-thyroid, which on the outer side 
of the larynx passes downward and forward from 
the lower part of the Tyroid to the anterior part 
of the cricoid cartilage. It pulls the anterior part 
of the cricoid cartilage upward, causing it to rotate 
round an axis, passing through its thyroid joints. 

The upper part of the cricoid, which carries the 
arytenoids, moves backward, and the attachments 
of the vocal chords are separated, and the mem- 
branes are put on the stretch. 

The requirements necessary for the production 
of voice are the following: 

Elasticity of the vocal chords, and smoothness 
of their edges, freedom of surface irregularity, such 
as thick mucus adhering to them or any abnormal- 
ity. The chords must be properly and accurately 



2 68 CARE OF THE BODY IN HEALTH AND DISEASE. 

adjusted, and closely approximated together so 
that they almost touch through their entire length, 
and they must be held in a certain degree of tension 
or when they vibrate, they cannot produce any 
vocal tone, but only a rough noise. 

The air must be propelled through the Glottis 
by a forced expiration; the normal expiratory cur- 
rent is too gentle to give the necessary vibration. 
After the operation tracheatomy, the air escapes 
through the abnormal opening, and sufficient pres- 
sure cannot be brought to bear on the chords so no 
vocal sound can be produced. A person speaks 
in a whisper, unless the escape of air, through the 
opening of the tube is prevented, by placing the 
finger, temporaarily upon the opening. 

The properties of the human voice are quality 
of pitch and intensity; the quality of the sounds 
of the voice is almost endless in variety. It would 
seem that no two persons have voices exactly alike. 
The sound of the human voice is regarded as a 
musical one. 

The quality of any musical sound, depends upon 
the relative power of the fundamental tone, and of 
the overtones that accompany it. The less the 
fundamental tone is disturbed by overtones, the 
clearer and better is the voice; this difference in 
quality of the human voice depends upon the per- 
fectness of the elasticity of the relation of thickness 
to length, surface smoothness and other physical 
conditions of the chords, themselves, and the ex- 
actitude with which the muscles can adapt the 
surfaces. 

To sing well, much more is necessary than a good 
quality of tone; good tones, if they were cultivated, 



VOICE) AND SPEECH. 269 

are common enough. The muscles of the larynx, 
thorax and mouth to produce good tones should 
all be educated to an extraordinarily high degree. 
The pitch of the notes produced in the larynx, 
depends upon First, the absolute length of the vocal 
chords; this varies with the age, especially so in 
males, whose vocal organs undergo rapid growth 
at Puberty, and renders vocalization uncertain 
in tone from the rapid changes going on in the part, 
hence the voice is said at this age to break or crack ; 
the vocal chords of women have been found by 
measurement to be about one-third shorter than 
those of men, and people with tenor voices have 
shorter chords than those, whose voices are bases. 
Secondly, it depends on the tension of the Chords ; 
the tighter the chords are drawn by the Crico- 
thyroid muscles, the higher are the notes produced 

Intensity or loudness of the voice, depends upon 
the strength of the current of the air. The more 
power the air blasts, the greater the amplitude of 
the vibration, and consequently the greater the 
sound. 

The more narrow the chinck of the Glottis, and 
the tighter the parallel chords are stretched, the 
less is the amount of air and the weaker is the blast 
required to set them in motion, and conversely 
the looser the chords, and the more widely separated 
they are, the greater the volume of the force of the 
air current necessary for their complete vibration; 
hence it is, that an intense vibration or loud note 
can be produced much more easily with notes of a 
high pitch, than with very low notes. 

The human voice, including every kind, is said 
to extend over about three and a half octaves. Of 



270 CARE OF THE BODY IN HEALTH AND DISEASE. 

this wide range an individual can seldom sing more 
than two octaves. During the ordinary vocal 
sounds, the air both in the resonating tubes above 
the Larynx and in the wind-pipe, coming from 
below is set vibrating, so that the Trachea and 
Bronchi act as resonators, as well as the Pharynx 
and Mouth. This may be recognized by placing 
the hand on the Thorax, when a distinct vibration 
is communicated from the chest wall. Such tones, 
for this reason are spoken of as chest notes. Aside 
of the chest tones of the ordinary voice, we can 
produce a higher pitch and of a different quality, 
which are called head notes, since this production 
is not accompanied by any vibration of the chest 
wall. The physical contrivance by means of this 
falsetto voice is produced is not very clearly made 
out. 

The following are the more probable views : 

First, it has been suggested that in a falsetto 
only the thin edges of the chords vibrate; the in- 
ternal Thyro-arytenoid muscles, keeping the base 
of the chord fixed, while with chest tones a greater 
surface of the chord is brought into play. 

Second, the chords are said to be wider apart in 
falsetto than in chest notes and consequently the 
Trachea ceases to act as readily. 

Third, the chords may be so arranged so that 
only one part of them can vibrate, and hence they 
act as shortened chords or a stop, being placed on 
the point where the vibrations cease, by the internal 
Thyro-arytenoid muscles, the production of a 
falsetto voice is distinctly voluntary, and is most 
likely dependent upon some muscular action in 
immediate relation to the chords, where it is always 



VOICE AND SPEECH. 271 

associated with the sensation of muscular exertion 
in the Larynx, as well as the changes that take 
place in the conformation of the mouth and other 
resonating tubes. 

The nervous mechanism by means of which 
vocal sounds are produced, are among the most 
complexly co-ordinated actions that regulate mus- 
cular movements. 

Like respiration, vocalization at first, seems a 
simple voluntary act. Sounds of various kinds 
will be produced by the individual. There can be 
no doubt, that the respiratory muscles, which work 
the bellows of the voice organ, are under the con- 
trol of the will so long as the respiration is not in- 
terfered with. 

The muscles of the mouth and throat, which 
shape the resonations, are also voluntary, but the 
intrinsic muscles of the Larynx are only voluntary 
to a certain degree, while in another, they are dis- 
tinctly involuntary, as seen in the spasm of the 
Larynx, for they are in part, at least controlled by 
impulses, which arise at the organ of hearing and 
pass some co-ordinating center, which arranges 
the finer muscular movements necessary to produce 
a certain note. 

When we sing a note, just struck on a musical 
instrument, we set the mouth and the special vo- 
calizing muscles in readiness by a voluntary act, 
for the proper application of the air blast, but the 
tuning of the vocal chords is accomplished for the 
most part at least by reflex impulses, arriving from 
the ear in a special co-ordinating nervous center, 
the education of which is in advance of that of the 
voluntary centers, and for that reason can only 



2 72 CARE OF THE BODY IN HEALTH AND DISEASE. 

be controlled by the latter in persons especially 
educated in singing. 

Some persons, who can sing a given note, with 
promptness and exactitude without any effort 
would find much difficulty in overcoming by voli- 
tion the accuracy of this perfect reflex mechanism; 
in fact, a person with a naturally good ear finds it 
difficult to sing out of tune, even if he try to do so, 
although, we feel that we have command over the 
pitch of the sounds produced in the I^arynx, we 
owe a great deal of our accuracy to the aid given 
us by our sound appreciating organs and the nerve 
centers in connection with them. The variations 
of the vocal sounds, which give rise to speech, are 
not altogether produced in the Larynx, but in the 
throat mouth and nose. 

When unaccompanied by any vocal sound, speech 
only gives rise to a whisper, but when a vocal tone 
is at the same time produced, we have the ordinary 
loud speaking, and as vocal tones can only be pro- 
duced by expiration, we can only speak aloud by 
means of an expiratory current of air, but an in- 
spiratory current may be made to give rise to a 
kind of a whisper. Speech is composed of two kinds 
of sounds, in one of w x hich the two sounds must be 
accompanied by a vocal tone, and are called vowel 
sounds, and in the other no vocal tone is necessary, 
but change in shape take place in the resonating 
chambers, so as to give rise to the noises called 
consonants. 

As the pronunciation of the consonants is always 
accompanied by some vowel sound, and as the 
difference between the vowels is brought about by 
changes in the shape of the mouth, the distinction 



VOICE AND SPEECH. 273 

between the two sets of sounds is rather artificial 
than real. The production of the different vowel 
sounds depends upon such a change being brought 
about in the cavity of the mouth that a resonator 
with a different individual note is formed for each 
particular word. 



2 74 CARE OF THE BODY IN HEALTH AND DISEASE. 



CHAPTER XVIII. 

THE URINARY EXCRETION. 

The Urine is the most important fluid excretion 
from the body. A large quantity of the waste 
products of the system is carried off in solution by 
the Urine. It has been said, that the amount car- 
ried off in this way, if allowed to remain in the sys- 
tem, would prove fatal in 24 hours. 

The construction of the Kidneys, which are the 
organs that eliminate these substances, together 
with the Urine, is somewhat peculiar. The renal 
artery, after it enters the Kidney, breaks up into a 
number of small branches. These little vessels 
form arches, which run along the base of the pyra- 
mids; from these arches, small straight branches 
spring and pass toward the surface which again 
give off lateral branches and each finally pass into 
a Malpighian Capsule. Within these little capsules, 
these little arteries break up into fine tufts of Capil- 
lary loops, and can only be clearly seen by the use 
of the Microscope. These little tufts are called 
Glomeruli; these Glomeruli fills the ends of the 
tubules, and is only covered by thin scaly epithelial 
cells, and is in this way separated from Urine. 

It is a peculiar fact that in the renal circulation 
the vessel leaving the Glomeruli, does not like most 
veinlets unite with others to form a large vein, but 
again breaks up into Capillaries, which form a 
dense net work around the convoluted tubules, 



THE URINARY EXCRETION. 275 

blood is then conveyed to small straight veins 
corresponding to the intralobular arteries. 

Another peculiarity of the Renal vessels, is that 
it has another distinct set of arteries, starting from 
the same point as the intra-lobular pass to the center 
of the gland into the pyramids, that consist of 
branches of straight arterioles, which lie between 
the straight and the looped tubules. 

Corresponding to these straight arteries, are 
minute straight veins, which deliver the blood 
back to the base of the pyramid; in the Kidney, 
then, we have three sets of Capillary vessels, which 
differ in their position, the form of their meshes, 
and their relation to their parent artery. It is 
likely that the pressure exerted by the blood in 
them by the rapidity of its flow through them differ 
also. 

The Capillaries in the Glomeruli are loops, col- 
lected into a tuft by their covering of delicate 
epithelium. On account of their relation to the 
afferent artery, which ends abruptly in these Capil- 
laries, and to the smaller afferent vessel, that leads 
to a secondary plexus of Capillaries, The pressure 
within the Glomerulus must be very great compared 
with that of the general Capillaries of the body. 
And must vary much with the changes in the local 
blood pressure. The walls of the vessels, in the 
Glomerulus are so constructed that they admit of 
the water passing through them, and carrying with 
the water in solution, Urea and other waste products 

The Capsules, as before mentioned, called the 
malpighian Capsules are the ends of the urinary 
tubules, and it should be remembered by the reader 
that they enclose these arterial tufts, or Glomeruli. 



276 CARE OF THE BODY IN HEALTH AND DISEASE. 

Now, all these urinary tubules empty their contents 
into what is called the Pelvis of the Kidney, which 
is a little funnel shaped sac, and forms the head of 
the Ureters, The Ureters are two small tubes, 
that lead from the Pelvis of the Kidney on either 
side and empty into the base of the bladder. The 
points in the bladder where the Ureters enter are 
guarded by a fold of tissue, that acts like a valve 
in such a way that when the Urine enters the blad- 
der, no matter how much it may become distended, 
the Urine can't go back up the Ureters. The 
Urine is constantly being excreted during life, as 
complete suspension of the function of the Kidneys 
is said to cause speedy death. 

THE PASSAGE OF URINE TO THE BLADDER. 

The pressure exerted by the blood in the Glomeruli, 
is quiet sufficient to make the Urine flow from the 
Pelvis of the Kidney, because when the Ureters 
are tied, they become distended above the ligature 
by the Urine flowing from the Pelvis, where a 
pressure may be produced of about forty millimeters, 
at which pressure, the secretion stops, and becomes 
somewhat changed in chemical composition, nor- 
mally, however, the passage of the Urine along 
the Ureters is accomplished by the peristaltic mo- 
tion of the ducts of the cells, which takes place 
alternately in the two Ureters; having reached the 
bladder, the Urine cannot return, as before stated, 
into the Ureters on account of the way the tubes 
pass through the walls of the bladder. 

When the pressure increases in the bladder, the 
ducts become closed and acts as a kind of a valve. 
The Urine, which is continuously secreted and con- 



THE URINARY EXCRETION. 277 

veyed to the bladder is only voided at convenient 
times, therefore special arrangements exist for its 
retension and expulsion. 

The retension of Urine in the bladder up to a 
certain point, depends upon the elasticity of the 
parts concerned; the dense elastic tissues around 
its outlet, being able to resist the elastic force being 
exerted upon its contents by the walls of the bladder 
and Viscera, thus where no active force can possi- 
bly come into play, as in the case of a dead subject 
or in complete paralysis following the destruction 
of the spinal chord, considerable amount of Urine 
is retained, but when a certain point is arrived at 
by a gradual accumulation of Urine within the 
bladder, the elasticity of the Sphincter, and the 
other tissues around the outlet is overcome by the 
elasticity of the bladder wall, and the Urine slowly 
dribbles away, but in a normal condition, the Urine 
is retained by a muscular mechanism, over which 
we have considerable control. 

The Sphincter, which by contracting, helps the 
elastic powers of the tissues around the Urethra, 
and retains the Urine. 

The accumulation of Urine after a certain time, 
gives a sensation known as a full bladder; this feel- 
ing is not always accompanied by the desire to 
make water, but in a short time it produces a desire 
in that direction. 

And we suppose that the stimulant given to the 
afferent nerve, by filling the bladder reflexly causes 
a constriction of the Sphincter muscle, so that in 
proportion that the pressure within the bladder 
increases, the resistance with outflow is also aug- 
mented; this does not imply any automatic action 



278 CARE OF THE BODY IN HEALTH AND DISEASE. 

of the Sphincter Vesicae, but merely a constant 
reflex action on that muscle, which secures its 
contraction, and the retension of a considerable 
amount of Urine without any voluntary influences 
or retension. 

When the bladder becomes very full, the reflex 
mechanism may require the assistance of the vol- 
untary centers to augment this power, and prevent 
the Urine from being evacuated. 

THE EVACUATION OE THE BLADDER. 

The expulsion of the Urine from the bladder 
does not normally depend on the elastic forces 
alone, as in the case of a paralytic incontinence, 
when the urine commences to dribble away, as 
soon as a certain pressure is attained within the 
bladder, but is accomplished by the Detrusor- 
Urinae, a sheet of muscle, which lies in the wall of 
the bladder. Under ordinary circumstances, there 
is a relationship between the expelling and retain- 
ing powers, in which the retaining power of the 
Sphincter is just able to resist the elastic pressure. 
If the Urine be retained for a considerable time, 
the reflex stimulation of the Sphincter no longer 
suffices to keep back the fluid, and the voluntary 
effort has to be called to the aid of the reflex action 
of the Sphincter. If now, a drop of Urine happen 
to make its way into the sensitive Urethra, matters 
are altered; even voluntary effort does not suffice 
to keep back the stream, and an irresistable call 
to empty the bladder is made upon the spinal nerve 
mechanism. This is accomplished by the contrac- 
tion of the muscular coat of the bladder, which is 
excited reflexly by the stimulus starting from the 



THE URINARY KXCRETION. 279 

mucus membrane lining the Urethra. When the 
Urine once commences to flow, it continues until 
the bladder is quite empty. 

The sequence of events will then be, first, stimu- 
lation of the mucus membrane of the Urethra by a 
drop of urine, second, contraction of the Detrusor- 
Urinary muscle, third, relaxation of the Sphincter, 
fourth, Rhythmical contraction of the ejaculator- 
Urinae, and finally a contraction of the Tevator- 
ani and neighboring muscles. The evacuation 
of the bladder under these circumstances is accom- 
plished independently of the will by a reflex action, 
and we may even be unconscious of it. This reflex 
evacuation of the bladder may occur during sleep, 
as the result of slight local excitations. In infants, 
this is the natural way of emptying the bladder, 
and the gradual education of the centers, controlling 
the retension mechanisms is watched with interest 
in young children. 

At an early age generally we learn to control 
the acts of these centers by our will; we feel a de- 
sire to empty the bladder before it becomes so dis- 
tended, that the reflex contraction of the Sphincter 
is insufficient to retain the Urine, but the volitions 
serve to call into activity the reflex mechanism 
just described. Almost at any time w r e call forth 
the reflax act by increasing the pressure on the 
bladder by voluntary contraction of the abdominal 
muscle. 

The Diaphragm being depressed and fixed, the 
muscles of expiration are put into action so as to 
press upon the present Viscera, at the same time 
the contraction of the Sphincter is probably checked 
by the will, and thus the power of retension is over- 



28o care: of thk body in health and disease. 

come. The moment the balance of power is turned 
in favor of the expelling agencies, a drop of Urine 
reaches the beginning of the Urethra, and excites 
reflexly the spinal centers, and thus brings about 
the complete evacuation of the bladder without 
further voluntary effort. 

The Urine of man, when freshly voided, is a 
clear straw colored fluid with a peculiar aromatic 
odor. The intensity of the color, varies with the 
amount of solids, the color being a rough indica- 
tion of the degree of concentration. On standing 
and cooling, a slight cloud of mucus often appears 
floating in the fluid. This is generated by the lin- 
ing membrane of the bladder. The fresh. Urine 
has a distinctly acid reaction. This does not de- 
pend upon the presence of free acid, but upon the 
larger amount of acid salts, particularly acid sodium 
phosphate, which it always contains. 

A strictly vegetable diet renders man's urine 
Alkaline, and it is said to become less acid after 
meals. 

In the herbivorous mammalia, the Urine is nor- 
mally alkaline, while their digestion is going on, 
but when they are deprived of food for some time, 
it becomes acid, thus showing that the alkalinity, 
depends upon their diet. 

The specific gravity of Urine varies greatly at 
different times, but in health it generally ranges 
from a thousand and fifteen to a thousand and 
twenty, after copious drinking, and an abstinence 
from proteid food, and in cool weather it may fall 
as low as a thousand and three, and after being 
deprived of fluids for a considerable time, and from 
animal food, and by a very active sweating, it may 



THE URINARY EXCRETION. 28l 

have a specific gravity as high as a thousand and 
forty. 

The quantity of Urine secreted is also very vari- 
able. In health, an adult usually makes about two 
pints per day. 

The amount is increased, first, by the general 
blood pressure or the pressure in the arteries 
from any cause whatever, second, the con- 
traction of the vessels of the skin, as from 
cold, third, drinking copiously of water or any 
fluid that contains it, fourth, an excess of 
nitrogenous diet, fifth, the presence of soluble 
matter in the blood, such as sugar and salt, 
and sixth, the presence of Urea as well as various 
medicines has a special action on the renal secre- 
tion, greatly increasing the amount of Urine passed ; 
although the quantity of Urine differs so much 
under different circumstances, the amount of solids 
discharged by the Kidneys in the twenty-four hours 
remains pretty near the same, being on an average 
of about an ounce and a half for an adult man; 
from this, it is clear that the height of the specific 
gravity must vary inversely with the amount se- 
creted, so that the more scanty the Urine is, the 
higher we expect to find the percentage of solids. 

The quantity of Urine excreted is diminished 
in a number of diseases, in fact, in almost all severe 
diseases, the function of the Kidneys is impaired, 
it therefore becomes an important duty of a Phys- 
ician to pay particular attention to the quantity 
of Urine expelled. It has already been mentioned 
that in health an adult person discharges on an 
average of about two pints of Urine; now in severe 
fevers this quantity is always greatly diminished, 



282 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

for an example; in a case of Typhoid fever, in the 
first ten days of the disease, this quantity would 
most likely be reduced to sixteen or eighteen ounces, 
then if the Urine is measured each day, and is 
found to be diminished one or two ounces every 
day, the patient is most likely getting worse, and 
when this quantity would be reduced four or five 
ounces in twenty-four hours, the case is most likely 
to be a very grave one, but in case the quantity 
is reduced to this low amount and begins to be 
restored again, or increased in amount it is almost 
a sure sign that the patient is getting better. It 
therefore, becomes a very important duty of the 
Physician in all severe fevers to look closely after 
the quantity of urine expelled daily. 

The color of the urine should be noted, and when 
necessary a test be made for albumen, sugar, etc. 



THE NUTRITION OF THE BODY. 283 



CHAPTER XIX. 

THE NUTRITION OF THE BODY, 

We are to some extent enabled to compare the 
intake and out-put of the human body, and are 
now in a position to see what light can be thrown 
by this comparison upon the changes, which take 
place in the body. 

It is known that the income is made up of the 
same substances, that are found in the body and 
of course are taken in, in the form of foods. 

Under the classes of food stuffs Albuminates or 
Proteids, fats, Carbo-hydrates, salts and water, 
which is necessary introduced into the stomach 
and Oxygen, which is taken by the lungs. 

While the outgo consists of Urea and some other 
waste products, which are eliminated in solution 
by the Urine. 

Carbon-dioxide, which is in the form of a gas is 
eliminated by the breath and the Feces, which is 
eliminated by the bowels and several indefinite 
substances eliminated by the mucus membranes, 
such as the air passages, and considerable waste 
go off by the skin together with a considerable 
quantity of water from all these ways of excretion. 
The milk ova and seamen may be omitted, as being 
devoted to special Physical purposes. 

In order that the body shall maintain its healthy 
standard it is necessary that the income should 
at least be equal to the loss or out-put, that is, of 



284 CARE OF THE BODY IN HEALTH AND DISEASE. 

all the necessary constituents of the body, and where 
growth is going on this is not sufficient. The in- 
come in this case has to be equal to the expenditure 
plus an allowance for growth; it is known that 
animals can live a considerable time without food, 
in this case the expenditure is derived from the 
body itself. It is absolutely necessary to sustain 
life and therefore the outgoings must still continue. 

It would appear that we ought to be able to ar- 
rive in a very simple manner at the smallest amount 
for maintaining the body at the standard named 
above, but in considering the many factors, that 
enter into the subject, it is not as simple a matter 
as might be supposed: 

First, a considerable margin over and above 
this minimum quantity is necessary in order to 
establish the nutritive equilibrium, and second, 
that the portion of material eliminated and stored 
up in the body varies according as the amount 
taken is increased or diminished; third and finally 
the quality of the food, that is, the proportion of 
each group of food stuffs, that is present in the diet 
has a very important influence on the quantity 
required to establish the equilibrium, and that 
best suited to cause increase of weight or to fatten. 

When deprived of food, those tissues upon the 
activity of which life immediately depends must 
feed upon materials stored up in some tissues of 
less vital importance to the animal. The first 
question to discuss is how much the body loses in 
daily weight during the time that it is feeding on 
itself and how fair the different individual tissues 
contribute to this loss. In making experiments 
Upon animals, the loss of weight is directly estimated 



THE NUTRITION OF THE BODY. 285 

by weighing the animal, and the loss of the individ- 
ual tissues is made out by a careful analysis of all 
the excretions by which the exact amount of Ni- 
trogen and Carbon-dioxide is ascertained. 

The Nitrogen will correspond to the loss of mus- 
cle, and the Carbon, after excluding the part which 
is the outcome of muscle change, which may be 
calculated from the Nitrogen corresponds to the 
fat burned off or oxidized in the system. 

It has been found that a starving animal loses 
weight most rapidly at first or in other words just 
after being cut off from food and later on more 
slowly. The cause of this difference is that the 
food last eaten continues to have an influence dur- 
ing the first three or four days, and the materials 
eliminated are in proportion larger in quantity. 
When the influence of food prior to starvation has 
ceased,, the daily amount of materials eliminated 
is much reduced, and remain nearly constant, 
decreasing slightly in proportion as the body weight 
diminishes until the animal dies. Adult animals 
generallv live until they have lost about half their 
normal body weight, when placed on starvation. 
Young animals however, do not bear starvation 
to a like extent and generally die, when they 
have lost twenty per cent, of their weight. 

An animal fed on a quantity equal to the output 
during starvation, continues to lose weight, and 
the quantity of nitrogenous substances eliminated 
is in excess of the low standard found during com- 
plete abstinence from food. From this, we might 
conclude that even when supplied with an amount 
of nitrogenous material equal to that used by the 
tissues during starvation, an animal takes a further 



2 86 CARE OF THE BODY IN HEALTH AND DISEASE. 

supply from its own texture, and eliminates some 
of the nitrogenous nutriment without making use 
of it. 

The body subsists on the scanty allowance of 
nourishment it gets from the tissues during star- 
vation only so long as there is absolutely no food 
income. When food is supplied, there is always 
an increased expenditure set up. 

The income is exceeded and the deficiency occurs 
in the nitrogenous balance, most likely some of 
the nitrogenous nourishment is rendered useless 
by the processes which it undergoes in the diges- 
tive apparatus; even then the quantity is not suffi- 
cient to support the equalibrium. It might be 
concluded then that feeding an animal on an amount 
of food, exactly corresponding to the quantity of 
nourishment, taken from the tissues, when totally 
deprived of food is only a slower form of starvation. 
In the case, in which a nutritive equalibrium is 
exactly maintained so that the body weight re- 
mains unaltered is the most important one for us 
to determine, since the settlement of this question 
would enable us to fix the most beneficial standard 
of diet. Unfortunately, this case is also one of the 
most difficult to come to a satisfactory conclu- 
sion, even when the amounts of gain and loss ex- 
actly correspond, we are yet unable to say that we 
have the best dietary, because some of the income 
of food taken may be altogether useless, and pass 
out of the body without performing any function 
whatever. 

It has been seen that the relative amounts of 
the out-put and the materials stored up in the sys- 
tem are altered and regulated by the amount of 



THE NUTRITION OF THE BODY. 287 

income, and we find that the quality of the income, 
that is, the relative proportions of the various kinds 
of food has a very material influence on the materials 
stored away in the system, and that which is elimi- 
nated from the body. 

Different animals appear to have very different 
powers of assimilation, and under varying circum- 
stances the requirements of the assimilative power 
of the same animal may vary. An animal fed 
upon a purely meat diet, requires a great amount 
of it to sustain his body weight. 

It has been found by experiment, that at least 
one twentieth of the body weight of a lean meat 
diet, given daily is necessary to keep an animal 
alive without either losing or gaining weight. If 
more than this amount be given, the animal may 
increase in weight, and as its weight increases, a 
greater amount of meat is required to keep it up 
to the new standard so that the progressive increase 
of weight with a purely meat diet is to keep on 
increasing the quantity of meat diet given. 

The effect of a diet without any albuminates 
whatever is that the animal dies of starvation 
nearly as soon as if deprived of all forms of food. 
The addition of fat or sugar to meat diets allows 
a considerable reduction in the supply of meat, 
both the body weight and the nitrogenous tissue 
change, preserving their equalibrium on a much 
less amount of food, and further fats and sugars, 
which obviously cannot form a sufficient diet for 
the reason that they contain no nitrogen appear 
to have the power of accomplishing some end in 
the body which without them, requires a consider- 
able expenditure of materials or food stuffs, con- 



288 care: of the body in HEALTH AND DISEASE. 

taining Nitrogen. Fats and sugars, then supply 
the body with readily oxidized materials and thus 
shield the albuminous tissues from oxidation, as 
well as reduce absolutely the nitrogenous metabol- 
ism. 

The last case we have to consider, is that in which 
the supply of food material is in excess of the re- 
quirements of the body. This is regarded as the 
most common case in man. Much of the food 
taken never really enters the system, but is conveyed 
away by the eliminative organs without being- 
utilized by the system. We may say then that 
all food stuffs are destined to feed the living cells, 
whether it be in the form of gland cells of the con- 
nective tissues of muscle cells, so that all food stuffs, 
that are really assimilated contribute to the main- 
tenance of the body, and subserve its various func- 
tions. Some produce fat, some Glycogen and others 
manufacture the various substances we find in the 
secretions, while yet others are devoted to setting 
free the energy of the various chemical changes 
taking place in the body, but all the food we eat 
is not assimilated. Indeed, the destiny of many 
of the ingredients of our complex dietaries is not 
easily traced out. 

The question of the exact amount of the various 
food stuffs to form the most wholesome dietary is 
one of very great practical importance, and would 
require a more elaborate discussion than can here 
be given. As a rule, men, like other animals par- 
take of food largely in excess of their requirements, 
when they are able to obtain it. It is well known 
that very fat persons are not those, who consume 
the largest amounts of food. 



THE NUTRITION OF THE) BODY. 289 

An adult man should be well nourished if he be 
supplied with the following daily diet: 

Albuminates 3 ounces. 

Hydro-carbons or fats 3 ounces. 

Carbo-hydrates or starches & sugars. . . 10 ounces. 

Mineral Salts i ounce. 

Water 3 pints. 

As a matter of fact, many persons can and do 
thrive on a much less quantity than is indicated 
in the above table. Individual taste commonly 
selects foods with too much of the Albuminates. 
Upon the whole a mixed diet is by far the best. 



29O CARE OF THE BODY IN HEAI/TH AND DISEASE. 



CHAPTER XX. 

THE PHASES OF HUMAN LIFE. 

One of the most interesting, as well as one of the 
most peculiar conditions connected with our being 
might be called THE PHASES OF HUMAN LIFE. 

In the beginning of human life a very strange 
occurrence takes place that has been discussed by 
physiologists from time immemorial, and no more 
seems to be known of its cause at the present day 
than in former times. 

After the female becomes pregnant, in spite of 
the womb enlarging most rapidly for nine months, 
or near that period, until it assumes an enormous 
size, no contractions are set up to expel its con- 
tents. At about the end of the ninth month con- 
tractions will be set up and it is very surprising to 
see the force there is in a sheet of muscle aided by 
the abdominal muscles, to drive out the contents 
of the uterus, which is the child. 

The development of the child is somewhat in 
this order. It is chiefly by the accumulation of 
muscle or flesh that the child acquires the bulk 
and weight of the man. The skeleton frame work, 
in spite of its being specifically lighter in its earlier 
condition, maintains throughout life, about the 
same relative weight. 

The increase in stature or height is very rapid 
in early infancy; proceeding however by decrease 
in degrees. According to some physiologists there 



THE PHASES OF HUMAN LTFE. 29 1 

is a gain of 5 or 6 inches during the first year in 
height. During the second year, probably 4 or 5 
inches ; during the third year, 3 or 4 inches in height 
is usually gained, and so on, decreasing to 2 or 3 
inches and still lower to maturity. 

During or shortly before puberty there is again 
a somewhat sudden rise with a subsequent more 
steady, but diminishing in increase up to about the 
twenty-fifth vear. From thence to about fifty 
years of age the height remains stationery, after 
which there may be a decrease, especially in ex- 
treme old age. The increase in weight is also very 
rapid at first, and proceeding like the height, with 
diminishing degrees, may continue until about the 
fortieth year. After the sixtieth year there is a 
slight decline very generally witnessed. It is a 
remarkable fact however that in the first few days 
of life, so far from there being an increase there is 
an actual decrease of weight. Even at the seventh 
day the weight is a little less than it is at first. 
The heart of the baby, as related to its body weight, 
is larger than the adult; and the frequency of the 
heart beat, much greater. The pulsations at birth 
are generally from 130 to 140 a minute, falling to 
about no pulsations per minute in the second year; 
and by the time the child is ten years old its pulse 
at rest is in the neighborhood of ninety per minute. 

Corresponding to the small bulk of the body 
the whole circuit of the blood system is traversed 
in a shorter time than in the adult. It only takes 
about twelve seconds for the blood to traverse 
the whole body in the infant; and in consequence 
of this renewal of the blood in the tissues is exceed- 
ingly rapid. The breathing of the child is much 



292 CARE OF THE BODY IN HEALTH AND DISEASE. 

quicker than that of the adult; being at first about 
thirty-five per minute, falling to twenty-eight 
per minute in the second year, and thence to twen- 
ty-six in the fifth year, and so on. 

The respiratory work, while it increases absolutely 
as the body grows, is as related to the body weight, 
greatest in the earlier years. It might be noted 
that the absorption of oxygen is said to be rela- 
tively more active than the production of carbon- 
dioxide; that is, there is a continued accumulation 
of capital in the form of a store of oxygen holding 
explosive compounds. This indeed, is the striking 
feature of infant metabolism. It is a metabolism 
directed largely to constructive ends. The food 
taken represents so much potential energy, but 
before that energy can assume a vital mode the 
food must be converted into tissue; and in such a 
convertion, a large amount of energy must be ex- 
pended. 

The metabolic activities of the infant are more 
pronounced than those of the adult; for the sake 
not so much of energies which are spent on the 
world without, as of energies which are for awhile 
buried in an increasing mass of flesh. Thus the 
infant requires over and above the wants of man; 
not only an income of energy corresponding to the 
energy of the flesh actually laid on, but also an 
income corresponding to the energy used up in 
making that living flesh out of the dead proteids, 
fats, carbo-hydrates, and salts, which serve as food, 
and were discussed in the beginning of this book. 
Above this the infant needs a more rapid change 
of tissue or metabolism to keep up the body tem- 
perature, which is no less but indeed is often found 



THE PHASES OF HUMAN UFE. 293 

slightly higher than the temperature of the adult, 
and it requires a greater expenditure in as much as 
the infant, with its much greater surface according 
to size, and its extreme vascular skin loses heat to 
a proportionately much greater degree than does 
the grown up man ; and it is well known that children 
are far more easily affected by cold than adults. 
This rapid metabolism is however manifest imme- 
diately after birth. During the first few days, 
the time during which the body loses weight, which 
has already been mentioned, the breathing activ- 
ities of the child are feeble. The embryonic habits 
seem as yet not to have been completely thrown 
off, and in consequence a new borne baby can bear 
with impunity a deprivation of oxygen which would 
be fatal to it later on in life. 

The quantity of urine passed, though scant in 
the first two or three days, rises rapidly at the end 
of the first week, and in youth the quantity of urine 
passed is as related to the body weight, larger than 
it is in the adult, This may be, at least in quite 
early life, due to the more liquid nature of the food, 
but is also in part the result of the more active 
metabolism; for not only is the quantity of urine 
passed, but also the amount of urea and some other 
urinary constituents excreted as related to the body 
weight, greater in the child than in the adult. The 
presence of the various acids, which occur in urine 
are more abundant, and their abundance is charac- 
teristic of the urine of children. Associated with 
these constructive labors of the growing frame is 
the prominence of the lymphatic system. Not 
only are the lymphatic glands largely developed 



294 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

and more active, but the quantity of lymph circu- 
lation is greater than in later years. 

Characteristic of youth is the size of the thymus 
body which increases up to the second year and then 
it remains awhile stationary; but generally before 
puberty it has undergone retrogression, and in the 
adult there is hardly a vestige of it remains. 

Our knowledge of the details of the working of 
the nervous system and the condition of the mind 
in early infancy is too obscure to allow of any very 
profitable discussion. It might be said that in the 
young child the whole nervous system is more 
excitable than in later years, by which we mean 
that it is less rigid, less marked out and spoken of 
as nervous mechanisms. 

According to some physiologists who have made 
a number of experiments upon animals, given areas 
in the brain of new-borne animals does not give 
rise to the usual localized movements. The sense 
of touch, both as regards pressure and temperature, 
appears to be well developed in the infant as does 
also the sense of taste. According to some the 
sense of smell is not so acute as it is in the adult. 
The pupils of the eyes, which are larger than in the 
adult, from the outset appear to be fully sensitive 
to light; 'though vision is not perfect as it is in the 
adult. As regards hearing on the other hand, very 
little reaction follows upon sound. Hearing seems 
to be very dull; especially during the first few days 
of life. This is likely in part, due to absence of air 
from the tympanic cavity and the swollen condi- 
tion of the mucuous membrane of the ear. As the 
child grows up his senses rapidly culminate and in 
his early years he generally has a cuteness of vision, 



THE PHASES OF HUMAN LIFE- 295 

hearing and. touch, which frequently become blunted 
as his psychical life becomes fuller. Children how- 
ever, are said to be less apt at distinguishing colors 
than in discerning objects; but it does not appear 
clear whether this is owing to a want of perceptive 
discrimination or from their being actually less 
sensitive to the variations in hue. A peculiar 
characteristic of the nervous system in childhood, 
which is thought to be the result of the more active 
metabolism of the body is the necessity for a long 
deep sleep. The appearance of the teeth marks 
the first epoch of a new life. At about seven months 
the two central incisors of the lower jaw make their 
way through the gum followed immediately by 
the corresponding teeth in the upper jaw. The 
lateral incisors first of the lower and then of the 
upper jaw appear about the ninth month. The 
first molars at about the twelfth month, the canines 
at about a year and a half, and the temporary den- 
tition is completed by the appearance of the second 
molars usually before the end of the second 
year. About the sixth year the permanent 
teeth begin to make their appearance by the 
appearance of the permanent molar beyond 
the second temporary molar. In the seventh 
year the central permanent incisors replace 
their temporary representatives ; followed Jin the 
next year by the lateral incisors. In the ninth 
year the temporary first molars are replaced by 
the first bicuspids, and in the tenth year the second 
temporary molars are replaced by the second bicus- 
pids. The canines are exchanged about the elev- 
enth or twelfth year; and the second permanent 
molars are cut about the eleventh or twelfth year. 



296 CARE OK THE BODY IN HEALTH AND DISEASE. 

There is then a long pause. The third or wisdom 
tooth does not make its appearance until the 17th 
or even 25th year; or in some cases not appearing 
at all. Shortly after the conclusion of the perman- 
ent dentition, with the exception of the wisdom 
teeth, the occurrence of puberty marks the phase 
of a new life; and the difference between the sexes, 
which has been merely potential now becomes 
functional. In both sexes the maturation of the 
generative organs is accompanied by the well known 
changes in the body at large, but the events are 
much more characteristic in the female than in 
the male; 'though in the boy the breaking of the 
voice and the rapid growth of the beard which ac- 
company the appearance of active spermatozoa 
are striking features; yet they are after all superfi- 
cial. The curves of his increasing weight and height 
and of the other events of his economy pursue 
for awhile longer, an unchanged course. The boy 
does not become a man until some years after pu- 
berty, and the decline of his functional manhood 
is so gradual that frequently it ceases only when 
disease puts an end to a ripe age. With the occur- 
rence of menstruation at from thirteen to seventeen 
years of age, the girl almost at once becomes a 
woman; and her functional womanhood ceases 
suddenly at what is called the climacteric or change 
of life. In the fifth decade or from forty to fifty 
years of age, during the whole of the child bearing 
period, she is in a comparatively stationary condi- 
tion ; while before the age of puberty up to about 
the elventh or twelfth year the girl is lighter and 
shorter than the boy of the same age. In the next 
few years her rate of growth exceeds his, She has 



THE PHASES OF HUMAN LIFE. 297 

then nearly reached her full development while 
the boy still continues to grow. Her curve of 
weight from the nineteenth year to the climacteric 
remains stationary; being followed later by an in- 
crease as a rule; so while the man reaches his max- 
imum weight at about forty, the woman is at her 
greatest weight at about fifty. 

Of some of the peculiar differences of the sex 
such as the formation of the pelvis and the costal 
mechanism of respiration are directly connected 
with the action of childbearing, while others have 
only an indirect relation to that duty, and indica- 
tions at least of nearly all the characteristics are 
seen at birth. 

The boy is heavier and taller than the baby girl, 
and the maiden of five breathes with her ribs in 
the same way as does the matron at forty. The 
woman is lighter and shorter than the man. The 
muscular system and the skeleton are lighter and 
less in the woman than in the man, and the brain 
of woman is lighter and smaller than that of the 
man. Her metabolism as measured by the respir- 
atory and urinary excreta is also less to the body 
weight, and her blood is less in quantity, but its 
specific gravity is less, and the proportion of red 
blood corpuscles are less. Her strength is consid- 
erably less, and her step is shorter. 

From birth the increase of growth progressively 
diminishes, and at last a point is reached at which 
the curve cuts a line and the increase is converted 
into a decrease. After the culmination of manhood 
at forty, and womanhood at the climacteric, the 
prime of life declines into old age. The activity 
of the body, which at first was sufficient, not only 



298 CARE OF THE BODY IN HEALTH AND DISEASE. 

to cover the daily waste, but to add new material, 
later on is able only to meet the daily wants, and at 
last it is too imperfect even to sustain in its entirely 
the existing frame. Neither as regards vigor and 
capacity of function or as regard weight and bulk 
do the turning point of the several tissues and organs 
coincide either with each other or with that of the 
body at large. 

The eye is in its dioptric prime in childhood, 
when its media are clearest and its muscular me- 
chanism most mobile, and then it for the most 
part serves as a toy. In later years when it could 
be of the greatest service to a brain that is still very 
active it is often fallen into a clouded and rigid old 
age. The skeleton reaches its limit very nearly 
at the same time, as the whole frame reaches its 
maximum of height. In a similar manner the 
muscular system in its increase corresponds with 
the weight of the body. The brain in spite of in- 
creasing complexity of structure and function, to 
which it continues to attain even in middle life, 
early reaches its limit of bulk and weight. At 
about seven years of age it attains what is consid- 
ered as its first limit, for although it may increase 
somewhat up to twenty, thirty or even later years 
its increase in weight is very much slower than 
before seven. The vascular and digestive organs 
as a whole, generally continue to increase even to 
a very late period. From these facts it is clear 
that though the phenomena of old age are at the 
bottom, the result of the individual decline of the 
several tissues, they owe many of their features 
to the disarrangement of the body produced by 



the: phases of human ufe. 299 

the premature decay or disappearance of one or 
other of the constituent bodily factors. 

There are two changes peculiar to old age; cal- 
careous and fatty degenerations. In the former 
of these changes the tissues are hardened and more 
readily break down or become of less service so 
that when it takes place in the vessels as the great 
arteries at an early period of life, which is not very 
common, the man will be called an old man, for a 
rigid artery is liable to break down at any time as 
in appoplexy, and hemorrhage of the lungs, and 
kidney disease. In the last named, or fatty de- 
generation, instead of the fat being a store to draw 
upon it often becomes a burden, and is found in 
unsuitable situations; about the heart for instance, 
which becomes a disturbing factor and often proves 
fatal. Of the various tissues of the body, the mus- 
cular and the nervous are however with those in 
which functional decline if not structural decay, 
as a rule soonest make their appearance. The 
co-efficient strength of the skeletal muscles gener- 
ally diminished after forty years of life, and a sim- 
ilar want of power comes over the plain muscles 
also. The heart for instance, 'though it may not 
diminish, or even it may still increase in weight, 
possesses less and less force; and the movements 
of the intestines, bladder and other organs diminish 
in vigor. 

In the nervous system the lines of resistance 
which we have seen, help to map out the central 
organs into mechanisms becomes weakened; the 
eye becomes feeble; not only from the cloudiness 
of the media and presbyopia, but also from the 
very obtuseness of the retina. 



360 CARE} OF THE BODY IN HEALTH AND DISEASE. 

The Sensory and motor impulses pass with in- 
creasing slowness to and from the central nervous 
system, and the brain becomes a more and more 
rigid mass of nervous cells, the molecular lines of 
which mark the history of past actions than serve 
as indications of present potency. The glandular 
elements seem to be those whose powers are the 
longest preserved; and the man who in the prime 
of his manhood was a martyr to dyspepsia by rea- 
son of the sensitiveness of his gastric nerve and 
reflex inhibitory and other results of their irrita- 
tion in his later years when his nerves are blunted 
and when therefore his peptic cells are able to pur- 
sue their chemical w T ork undisturbed by extrinsic 
nervous worries, eats and drinks with the courage 
and success of a boy. 

Within the range of a lifetime are comprised 
many periods of more or less frequent recurrence. 
In spite of the aids of a high civilization all tending 
to render the condition of his life more and more 
equitable man still shows in his person the effects 
of the seasons. Some of these are the direct results 
of varying temperature, such as the gain of weight 
in winter and the loss in summer. 

Within the year an approximately monthly 
period is manifested in the female by menstruation, 
but there is no similar latent cycle in the male. 
The peculiarity of recurrent diseases and the crit- 
ical days of some diseases may be regarded as point- 
ing to cycles of small duration; but these cycles 
are no doubt due in some diseases to the life and 
activity of micro-organisms. Prominent among 
all other cycles is that man must night after night 
or day after day, or at least time after time lay 



THE PHASES OF HUMAN LIFE. 3OI 

down to sleep. The salient feature of sleep is the 
cessation of the automatic activity of the brain. 
All parts of the body either directly or indirectly 
take part in it. The pulse and breathing are slow, 
the intestines and other internal muscular mechan- 
isms are more or less at rest; the secreting organs 
are less active, and the whole metabolism and the 
dependent temperature of the body are lower; but 
we are unable to say how far these are the indirect 
results of the condition of the nervous system; or 
how far they indicate a partial slumbering of the 
several tissues. We are not at present in a position 
to trace out the events which culminate in the 
inactivity of the brain. It has been argued that 
during sleep the brain is anemic; or in other words 
that blood does not flow freely to the brain. 

The anemic condition of the brain is more likely 
the result of sleep than its cause. Truly enough 
when the heart is in an excited condition and en- 
gorges the vessels of the brain it hinders sleep, 
but it is hardly reasonable to believe that a moder- 
ate amount of blood sent to the brain would hinder 
sleep. The cause of sleep would more likely have 
to be sought in the condition of the cells of the brain 
It resembles the heart inasmuch as irritability is 
lowest at the beginning of the diastole and increases 
onward until a beat burst out; so is sleep deepest 
at its commencement after the day's labor; then 
it becomes slighter and slighter stimuli are needed 
to awake the sleeper. As to the changes that take 
place in the cells of the brain during sleep we know 
very little. Physiologists have studied the sub- 
ject by experiments on animals and otherwise 
but they still leave the subject very obscure. 



302 CARE OF THE BODY IN HEALTH AND DISEASE. 

In order to promote sleep one should lie down, 
Comfort contributes considerably to sleep. The 
health of the individual influences sleep; the state 
of the mind influences sleep materially. In order 
to sleep one should dismiss from his mind all cares 
of business. In case a person suffers from inability 
to sleep a warm bath often promotes sleep just 
before going to bed. Stimulants like coffee and 
tea are a hinderance to sleep. An ill ventilated 
room will often disturb sleep. 

Persons when they are very hungry cannot 
sleep well. Those who suffer from sleeplessness 
can sometimes get relief by taking a supper just 
before retiring, like sw T eet milk. When natural 
sleep can be produced it is always better than to 
take drugs, but sometimes it becomes necessary 
to have recourse to drugs, but it is not advisable 
to use them night after night, as the person is likely 
to form a habit and possibly be unable to sleep 
entirely without them. 

Exercise and labor promotes sleep, and persons 
that suffer from insomnia should not fail to take 
the proper amount of exercise during the day; 
but too intense exercise of the mind often produces 
insomnia; so persons who wish to promote sleep 
should learn to change off from any annoying bus- 
iness that requires intense mental application. 
The cycle of the day is manifested in other w r ays 
than by the alternation of sleeping and .waking. 
With all the indirect effects of these conditions, 
there is a diurnal curve of temperature which 
appears independent of all the immediate circum- 
stances; the hereditary impress of long ancient 
sequence of days and nights. Even the pulse, 



THE PHASES OF HUMAN LIFE. 3O3 

which are so sensitive to all bodily changes shows 
running through all the immediate effects of the 
changes of the minute and the hour, the work of 
an influence which cannot be accounted for by 
waking and sleeping; and the same may be said 
concerning the rythm of respiration and the pro- 
ducts of the lungs, skin and urinary excretion. It 
would appear that there is a daily curve of body 
metabolism which is not the product of the day's 
events, and lastly, as the fundamental fact, of all 
bodily periodicity is that alternation of the heart's 
systole and diastole which ceases only at death. 
The flow in the arteries is toned down in the capil- 
laries to an apparently continuous flow; still the 
constantly repeated cycle of the heart's activity 
must leave its mark through the whole webb of 
the body's life. 

DEATH. 

Each individual, man, woman or child, might 
be said to represent a unit of a great generation 
passing through time. Statistics show that the 
average of human life in the government of the 
United States is a little higher at the present than 
it has been in a great while. The expectation of 
life from birth is now forty years. Expectation 
of life does not mean just how long one might ex- 
pect to live; it means the average of human life 
from any given period. 

After one passes from childhood, the expectation 
of life is increased a little, which again falls and 
gradually falls, up to the extreme limit of age. Thus 
the expectation of life of an individual at thirty 
years is thirty three years, which is now fallen from 



304 CARE OF THE BODY IN HEALTH AND DISEASE. 

what the expectation of life is from birth. This 
does not mean that a man at thirty might expect 
to just live thirty-three years ; it means that a large 
number of persons taken at that age; say every 
man in the United States, at the age of thirty years, 
live upon an average, thirty-three years, the whole 
of which will be sixty-three years; so the expecta- 
tion of life at thirty years would be thirty-three 
years plus the time he had already lived, which is 
thirty years. Then as we advance the expectation 
of life is gradually reduced up to one hundred and 
ten years, w^hich is considered the extreme limit 
of age where it then becomes naught. 

The animal body is in reality a vehicle for pro- 
duction; and after the life of the parent has become 
renewed in the offspring the body remains as a 
cast off envelope whose future is death. Were 
the frame of man not the complicated machine, 
it is known to be, death might come as a simple 
and gradual dissolution; being the last stage of 
loss of fundamental powers. As it is however 
death is always more or less violent. The machine 
comes to an end by reason of the disorder caused 
by the breaking down of some of its parts. Life 
ceases not because the powers of the whole body 
slacken and are lost, but because a weakness in one 
or other part of the machinery throws its whole 
working out of gear. 

The central factor of life is the circulation of the 
blood, but the blood is not only useless but injuri- 
ous unless it be properly oxygenated; and it is well 
known that in the higher animals the oxygenation 
of the blood can only be properly effected by reason 
of a breathing mechanism presided over by a su- 



THE PHASES OF HUMAN LIFE. 305 

preme nervous center. Thus the life of a complex 
animal is, when reduced to a simple form, composed 
of three factors; the maintenance of circulation, 
the access of the air to the hemoglobin of the blood 
and the functional activity of the respiratory cen- 
ter. The arrest of either one of these functions 
proves fatal. It has been put in this way; that 
death takes place by the heart or by the lungs or 
by the brain. In reality, when the analysis is 
pushed further the central fact of death is the 
stoppage of the heart and the consequent arrest 
of the circulation. The tissues then all die. be- 
cause they lose their internal medium — the blood. 
The failure of the heart may arise in itself on ac- 
count of some failure in its nervous or muscular 
elements, or by reason of some mischief effecting 
its mechanical working; or it may be due to the 
want of oxygenation of the blood, which in turn 
may be caused by either a change in the blood 
itself, as in carbon dioxide poisoning, or by a failure 
in the mechanical conditions of respiration, or by 
cessation of the action of the respiratory centers. 
The failure of this center, and even that of the heart 
itself may be caused by nervous influences coming 
from the brain, or brought into operation by means 
of the central nervous system. It may on the 
other hand, be due to an imperfect state of the 
blood, and this in turn, may arise from the imper- 
fect action of various secretory or other tissues. 

The modes of death are in reality as numerous 
as are the possible modifications of the various 
factors of life; but they all end in the stoppage of 
the circulation, and the withdrawal from the tissues 
of their internal medium ; hence we come to consider 



306 CARE OF THE BODY IN HEALTH AND DISEASE. 

the death of the body as marked by the cessation 
of the heart beat, a cessation from which no recov- 
ery is possible; and by this we are able to fix an 
exact time at which we say the body is dead. 



CARRIAGE OF THE BODY 307 



CHAPTER XXI. 

CARRIAGE OF THE BODY. 

It has been said that good health depends on a 
proper carriage of the body inasmuch as a graceful 
carriage of the body is to be admired there can be 
no doubt that it is also conducive to good health. 
All intelligent persons of refined taste are ready 
to recognize and admire the elastic step and the 
majestic mien; yet they often fail to utilize this 
graceful endowment of nature. While it is not 
desirable that every one should, stand, sit or move 
in precisely the same manner, yet there are certain 
laws in regard to both posture and attitude which 
if strictly observed will be conducive to health of 
body and beauty of form. As the proper carriage 
of the body; especially of its vital organs is both 
healthful and graceful, it is necessary to learn the 
position that each of its members should take. 
To make the subject plain I will here quote from 
Mrs. J. W. Shoemaker, in her book on advanced 
elocution : 

"The simplest position is to place the heels as 
closely together as the contour of the lower limbs 
will permit with the toes turned outward at an 
angle of about sixty degrees. The knees should 
be firm, the hips inward; the shoulders on a line 
with hips; held easily erect; with crown of head 
highest, chest raised; that is drawn up; thus liber- 
ating respiratory organs and abdominal viscera. 



368 CARE OF THE BODY IN HEALTH AND DISEASlt. 

Allow weight of body to rest on balls of feet ; stand- 
ing thus, the line of gravity falls between the feet 
near the line of the toes. In this position see that 
no part of the body is unduly tensioned, and that 
all the sustaining muscles are in tone but pliant. 
This is not only a good position for a proper carriage, 
but it is a fundamental in the regular gymnastic 
exercises; and from this other and more complex 
positions are taken. The line of gravity however, 
must not be broken nor distorted in passing from 
one basic position to another; for if this happens 
the entire body is thrown out of the lines of both 
strength and grace. The lower limbs being con- 
trolled by special laws relating to the centre of 
gravity the line of gravity becomes a controlling 
influence in standing or in moving; and any varia- 
tion of it mars the whole posture. 

THE USUAL FAULTS IN STANDING. 

Protruded chin, hollow or relaxed chest, pro- 
truded hips and abdomen, toes not at proper angles, 
both knees relaxed, arms hanging too far forward, 
looseness in all parts of the body, overnicety in all 
parts of the body, stiffness in all parts of the body. 

walking. 

Someone has said that all created things having 
the power of locomotion, except man, move in 
harmonious correspondence with the law of their 
nature. He alone hops and halts, trudges and 
strides, limps and ambles, and moves over the ground 
in a variety of other ways, all of which are in oppo- 
sition to the rhythmus of his being. Much of this 
without doubt is due to the environment incident 



CARRIAGE OF THE BODY. 309 

to civilized life, more to the burdens imposed upon 
humanity by the dicta of fashion, and still more 
to carelessness and ease of self. The need to man 
of walking no one will question. It is an absolute 
necessity. To walk easily and well should be de- 
sired by every one on account of comfort and health ; 
to walk elegantly should be coveted, for it is an art. 
When the right muscles are exercised and a proper 
pendulous action takes place, walking becomes a 
pleasure, because the exercise is made easy; because 
in itself it is exhilarating, and being mostly in the 
open air it is for both sexes a most healthful gym- 
nastic, 

FAUI/TS IN WALKING. 

Walking with weight on heels, thus jarring spine, 
bobbing body up and down, rolling gait, pitching 
gait, strutting gait, loose or shuffling gait, hip ac- 
tion, stiff leg, unequal or irregular step. 

Walking may be termed a series of arrested 
fallings, and has been uniquely defined as a steady 
forward movement of the torso through a regularly 
repeated action of the lower limbs. In other words, 
when there is an impulse to move the body forward 
the line of gravity immediately passes to one foot 
alone ; the other foot is then loosened from the earth 
and the knee is relaxed; the muscle between the 
knee and ankle are relieved of tension, and the 
limb is thrust forward or pried over in a lever like 
way by the powerful muscles of the thigh, in which 
the principal action in walking takes place. The 
foot is next set upon the ground, the ball of the 
foot touching first, if there is no artificial heel to 
prevent. If there is the heel touches the ground 



310 CARE OF THE BODY IN HEALTH AND DISEASE. 

first, but it should be the inner part of the heel; 
that is, the part nearest the ball of the foot, and 
almost simultaneously with this should be the 
touch of the ball of the foot. In a similar manner 
the other foot is carried forward, the repeated 
movement resulting in a pendulous action of the 
body, induced by the forward shifting of the line 
of gravity. The body inclines slightly forward 
to accommodate itself to these changes, but must 
not be bent at the hip. The head should be held 
easily but not stiffly erect, and in line with the 
continuously advancing limbs. The hands unless 
supporting or carrying some object, should be down 
at the side and allowed to share the easy pendulous 
action of the body so as to aid rather than hinder 
the elasticity of the step. For comfort and grace 
of movement the length of the step should not 
extend beyond the length of one's own foot; that 
is the advancing foot should be carried forward 
until the heel is distant one foot length from the 
toe of the stationary one. Of course when pupils 
are moving inline this cannot be so precisely followed ; 
then a regulation step must be adopted. In pre- 
senting the mechanical processes of good walking 
no attempt is made to correct individual peculiar 
ities, but simply to render it possible for each per- 
son to move in accord with a law by which all are 
governed; nor is there any attempt to repress the 
mood which may be dominating the mind, and 
which often influences the gait. The perfection 
of walking lies in a movement so steady that one 
is reminded of the gliding of a boat over a still 
stream, or the skimming of a swallow through the 
air. All exercises either in walking or marching, 



Carriage otf the body. 311 

should be taken in gymnastic shoes, or in easy 
shoes of light weight, without heels so that the 
foot may have, as nearly as possible, the freedom 
of a natural step. For outdoor exercise the shoes 
should be stouter with broad soles and low flat 
heels. 

SITTING. 

To assume an easy and upright attitude or posi- 
tion in sitting the following directions should be 
observed : 

Place one foot two or three inches back of the 
other; toes of both feet outward; the heel of the 
advanced foot toward the hollow of the backward 
one; then with line of gravity in backward limb 
with torso inclined forward and head slightly back- 
ward evenly sink to seat. 

RISING. 

In preparing to rise place the feet in position 
similar to that in preparing to sit, with weight in 
back limb, and with a slight inclination of torso 
and head. 

BOWING. 

Bowing is the most common of all salutations 
and consists ordinarily of simply a slight inclination 
of the head; but if occasion demand it may be the 
deeper and more reverential; one of the bending 
the body at the hips. Whichever mode is used 
it should be executed evenly, avoiding a quick or 
hesitating jerk. ' ' 



312 CARE OF THE BODY IN HEALTH AND DISEASE. 

I here introduce some of the more prominent 
basic positions of the body, which I quote from 
the author above quoted. 

i st. vStanding on a narrow base with weight 
upon foot directly under the body, the other slightly 
advanced, toes outward at the usual angle, knee 
of forward limb slightly relaxed, torso easily erect; 
the indication is that of dignity, calmness, passiv- 
ity, or repose. 

2d. With similar bearing of torso and foot 
placed as in principle first, but with w T eight upon 
forward foot, and backward when slightly lifted 
at heel and knee a little relaxed, the indication is 
that of quiet interest, attention or intention. 

3rd. With basic position same as in principle 
first but feet more separated in lengths, and with 
line of gravity in heel of backward foot, with torso 
somewhat relaxed in shoulders, the indication is 
that of meditation, abstraction or concentrated 
thought. 

4th. With basic position same as in principle 
second, but feet more separated in the lengths 
unsupporting foot on toe, its heel turned inward 
toward heel of sustaining foot, thus giving greater 
length to the limb; chest strongly raised, the indi- 
cation is that of active interest, desire, earnestness, 
eagerness, courage, boldness, enthusiasm or vehem- 
ence. 

5th. With feet considerably separated, back- 
ward limb supporting, knees relaxed, and torso 
retracted, with shoulders down forward and chest 
correspondingly inward, the indication is that of 
fear, dread, anguish or terror. 

6th. With feet considerably separated, weight 



CARRIAGE OF THE BODY. 313 

on backward limbs, but both limbs rigid, torso 
raised and tense, the indication is that of independ- 
ence, resistance, defiance, scorn, contempt or de- 
rision. 

7th. With heels closed, toes out at the usual 
angle, both limbs supporting, torso easily erect, 
the indication is that of respect, obedience or de- 
ference. 

8th. With feet somewhat separated and nearly 
parallel, both limbs supporting, the indication is 
that of weakness, infancy, decrepitude, or old age. 

9th. With feet close together and parallel, 
knees relaxed, chest and elbows inward, the indica- 
tion is that of timidity or want of self assertion. 

10th. With feet somewhat separated, toes point- 
ing forward, or turned slightly inward, and torso 
distorted, the indication is that of boorishness or 
rusticity. 

nth. With base broad, heels parallel, both 
limbs supporting, torso well drawn upward, the 
indication is that of familiarity, bravado or aston- 
ishment. 

1 2th. With short cat like movement on balls 
of feet, torso inclined forward and slightly bent 
at hips, the indication is that of caution, secrecy 
or scrutiny. 

13th. With frequent changes of balance from 
one foot to the other, the indication is that of an- 
xiety, nervousness or embarrassment. 

THE POSTURES OF THE HEAD. 

i st. Head level between shoulders, inclined 
neither to right nor left nor up nor down, the indi- 
cation is that of calmness, dignity or repose. 



314 car£ of i"hh body in hkavTh and disease. 

2d. Head toward object addressed or contem- 
plated, the indication is that of interest, sympathy, 
confidence, admiration or love. 

3rd. Head carried away from object addressed 
or contemplated, the indication is that of disdain, 
contempt, hautiness, suspicion or scorn. 

4th. With head forward and chin upward, the 
indication is that of hope, desire, petition or wor- 
ship. 

5th. Head down, chin in, the indication is that 
of resignation, humility, reverence, meditation, 
modesty, abasement or shame. 

6th. Head held erect, the indication is that of 
exultation, joy, courage or triumph. 

7th. Head same as preceding, but carried a 
little further backward, pride, anger or defiance. 

8th. The nod of the head forward is indicative 
of approval, affirmation, approbation, emphatic 
declaration. 

9th. The shake of the head or rotation is indie - 
itive of doubt, denial, nagation, exasperation or 
regret. 

10th. Head inclined toward either shoulder 
is indicitive of weariness, languor or doubt. 

nth. Head somewhat drooped is indicitive 
of sorrow, depression or discouragement. 

12th. Head thrust forward, the indication is 
that of scrutiny or curiosity. 



INDICATIONS OF CHARACTER. 



CHAPTER XXII. 

INDICATIONS OF CHARACTER. 

The facial expression; the eyes, complexion, 
color of the hair, conversation, mode of laughing, 
all form indications of character. 

A good face is not necessarily a beautiful one; 
but is a face of honesty and candor, which is better 
seen than described can be learned only by obser- 
vation. 

The eyes indicate a great deal; they love, they 
hate, they envy, they wither. 

Colors indicate qualities through all organic 
nature. Black indicates power, and generally ac- 
companies the powerful or motive temperament. 
Of this the black animals and the black races fur- 
nish examples. Dark complexioned persons gen- 
erally wield a powerful influence over those with 
whom they come in contact; especially the oppo- 
site sex. Black haired speakers carry their audi- 
ences with them as they please. This color is very 
appropriate to Politicians, Generals, and men in 
public business. The light complexioned races 
are much more progressive and refined than the 
dark, and also they are less sensual. Coarse black 
and coarse red hair, skin and whiskers indicate 
powerful animal passions, together with correspond- 
ing strength of character, while fine white and au- 
burn hair indicates quick susseptibilities with 



31 6 CARE OF THE BODY IN HEALTH AND DISEASE. 

refinement and good taste. Fine dark or brown 
hair indicates the combination of fine susseptibili- 
ties with great strength of character, while auburn 
hair and a florid countenance denotes the highest 
order of sentiment and intensitive of feeling alone 
with corresponding purity of character, combined 
with the highest capacities for enjoying and suffer 
ing. 

Intermediate colors and textures accompany 
intermediate characters. Curly hair and beard 
indicate an excitable and variable disposition with 
diversity of character. 

A dark haired female is able, if disposed, to con- 
trol a lover or husband as if by magic. He will 
be, as it were, spell-bound in her company, and 
feel that he has to do as she says. If she is good 
her influence in her family and circle will be su- 
preme and most beneficial, but if she is selfish she 
will by persuasion or force, bring all hands under 
her thumb. If she espouses good ends none can 
execute them better; if bad, none is more desper- 
ate. 

Black-haired bachelors usually play havoc with 
female hearts; breaking them right and left. A 
great amount of gender usually goes along with this 
complexion. It generally accompanies the power- 
ful or prominent organism. Red hair and impul- 
siveness generally accompany each other. Hearti- 
ness of soul, warmth and emotionality generally 
go with auburn hair and blue eyes. 

A brunette wife will be the more independent 
and efficient. A blonde more loving, clinging, 
tender, complying and dependent. The latter is 
the easier molded to your taste; the former will 



INDICATIONS OF CHARACTER. 3 I 7 

mould you to hers. If you desire refinement, taste, 
exquisiteness, gushing emotions, sweetness and 
purity, choose the blonde. If efficiency, energy 
and force, choose the brunette. 

Pale black indicates more burning intensity, 
more fervor of desire, more power to do, in short, 
more desperation than any other. It signifies the 
white heat of all the mental operations along with 
great endurance. 

Florid complexions and light hair usually go 
together. Dark-red, verging toward brown hair 
is a very excellent color. It indicates power with 
purity, strength with goodness, and sense with 
virtue. 

Flaxen hair and a light complexion verging to- 
ward pallor indicates quickness of perception and 
action, warm affections, a bright clear mind, good 
pure motives, taste, and a desirable character 
throughout. It is rarely accompanied with coarse- 
ness, either organic or passional. 

Grey eyes signify power in all the functions; 
strong and hearty passions, and vigorous intellect. 

The present state of the various functions are 
also indicated by the temporary color; as the var- 
iable colors of the cheek for the time being indicate 
the existing state of the health, so they equally 
indicate mental health and disease. 

Existing color proclaims existing organic and 
mental conditions. When the system is in a per- 
fectly healthy state, the Avhole face will be suffused 
with the glow of health and beauty, and have a red, 
but never an inflamed aspect; yet any permanent 
health injury which prostrates the bodily energies 
will derange this beautiful complexion into a dull- 



31 8 CARE OF THE BODY IN HEALTH AND DISEASE. 

ness of countenance, wliich indicates that but little 
blood comes to the surface or flows to the head, 
with a corresponding stagnation of the physical 
and mental powers. Yet this dullness frequently 
gives way to a firey redness, wliich is not that of 
health, but the redness of inflammation or false 
excitement. 

Dark or livid red faces, so far from indicating 
the most health often signify disease, and also 
animal and sensual characters. 

Gross sensualists of a depraved character, often 
have a fiery red countenance. Stand aloof from them 
for their passions are all on fire ready to ignite and 
explode on provocations so slight that a truly 
healthy mind would scarcely notice it. 

When the faculty of force is large, with bright 
scarlet red cheeks, it manifests itself in self-defense, 
energy and virtuous indignation. While with this 
faculty equally large, with a dark brown red. face 
the red diffused all over the face instead of confined 
to the cheeks, and of a dark, bloody, muddy hue, 
it signifies a perverted depraved action in wrath, 
violent fits of temper, vindictiveness, spite and ma- 
lice. 

The faculty of ambition large, with bright red 
cheeks loves praise, but has no envy or jealousy. 
It likes to be praised but is also willing for rivals 
to be praised. While this same amount of the 
faculty of ambition, with a livid red face signifies 
its diseased, distorted, perverted action, which 
creates envy, rivalry and jealousy. 

Love furnishes our best illustration of this point. 
Pure, elevating, sanctifying love, accompanies 
bright ^scarlet red in the cheeks, which vanishes 



INDICATIONS Otf CHARACTER. 319 

off into pink and then into a pure lilly white; while 
a dark brown, dull, muddy red, — not exactly red 
but a dingy brownish red, signifies an animalized 
state of amativeness and lust, along with sexual 
exhaustion. A good complexion then is something 
more than skin deep, and so is a poor one. 

Who does not know^ that the state of the health 
is largely indicated by the complexion? One may 
justly be proud of a good complexion and ashamed 
of a poor one; while all should try to keep theirs 
good by observing the laws of health. 

Well proportioned temperaments create harmoni- 
ous features, and symmetrical well balanced minds, 
whereas some of those whose features stand right 
out, and others fall in, have uneven ill-balanced 
characters; so that homely, disjointed exteriors 
indicate corresponding interiors; while evenly bal- 
anced and exquisitely well formed men and women 
have well balanced minds. It follows therefore, 
that woman more beautiful than man, has finer 
feelings and greater perfection of character, although 
she is less powerful ; and the more beautifully formed 
a given woman is, the more exquisite and perfect 
is her mentality. 

Nature never deceives by clothing that in a 
beautiful attractive exterior which is intrinsically 
bad. Truly enough, some of the handsomest women 
sometimes make the greatest scolds, and develop 
bad characters just as the sweetest things when 
sour becomes correspondingly sour; and the finest 
things when perverted become the worst. Those 
naturally beautiful and exquisitely organized, when 
perverted become proportionately bad; and those 
naturally ugly formed are naturally bad disposi- 



320 CARE OF THE BODY IN HEALTH AND DISEASE. - 

tioned. Homely persons however, are often good 
tempered benevolent and talented. 

The expressions of the eye convey precise ideas 
of the existing states of the mind and body. As 
long as the constitution remains unimpaired the 
eye is clear and bright but becomes languid and 
dull in proportion, as the brain has been enfeebled. 

Wild, demented persons have a half crazed ex- 
pression of the eye, while calmness, intelligence, 
purity, sweetness, love, sensuality, anger, and all 
the other mental states express themselves quite 
as distinctly by the eye as by the voice or any other 
mode of expression. 

Intonations express character. Whatever makes 
a noise, from the roar of the sea, whirlwind, or, 
through all forms of animal life, from the roar of 
the lion to the gentle voice of woman, creates a 
sound which agrees perfectly with its maker's 
character, while the rough and powerful bellow 
of the bull, the fierce yell of the tiger, the coarse 
mourn of the hyena, the sweet warblings of birds, 
all correspond perfectly with their respective char- 
acteristics, and this law holds equally true of men, 
therefore human intonations are as superior to 
brute as human character exceeds animal. Ac- 
cordingly the peculiarities of all human beings are 
expressed in their voices and modes of speaking. 
Coarse grain and powerful animal organizations, 
have a coarse, harsh and grating voice; while in 
exact proportion, as persons become refined and 
elevated mentally, will their tones of voice become 
correspondingly refined and perfected. We little 
realize how much character we infer from this 
source. Barbarous races use the guttural sounds 



INDICATIONS OF CHARACTER. 321 

more than the civilized; thus Indians talk more 
down their throats than white men. 

Those whose voices which are clear and distinct 
have clear minds, w^hile those who only half form 
their words or are heard indistinctly are mentally 
obtuse. Those who have sharp, shrill intonations 
have correspondingly intense feelings and equal 
sharpness both of anger and kindness; w r hereas 
those with smooth or sweet voices have correspond- 
ing evenness and goodness of character. These 
same persons not unfrequently combine both sharp- 
ness and softness of voice, and such always combine 
them in their character. There are also intellectual, 
moral, animal, selfish, mirthful, devout, loving, 
and many other intonations, each with correspond- 
ing peculiarities of character. In short, every 
individual is compelled by every word uttered, to 
manifest something of the true character. The 
underlying principle here involved, and means by 
which these tones proclaim the character, is this: 
Every faculty pervades the entire character of its 
possessor, and impresses itself it its relative degree 
of power upon everything he says, does and is; 
thus, kindness, devotion, firmness, taste, reason, 
the affections, and especially love, and every other 
faculty manifests their relative power and weakness 
in every tone and in every act. 

One has only to know each faculty by its 
characteristic signs to be able to determine 
from mere trifles and everything one says and 
does, just how much of this faculty and how 
little of that, each person possesses. Whoever 
meets you with a long low bow thinks more of you 
than he does of himself; but whoever greets you 



322 care: of the; body in h£ai/Th and dise;as£. 

with a short quick bow, with a half bow forward, 
and a bow and a half backward, thinks one of you 
and two of himself. Very firm men stand straight 
up and down, inclining not a hair's breadth forward 
nor backward; neither to the right nor the left; 
hence the expression, "he is an up and down man. ' 

Every primary element in the mind of man, of 
which each faculty is a representive, expresses it- 
self in everything everyone says and does, in propor- 
tion as it is developed. That is, each faculty de- 
clares itself and its relative force in everything, 
each appertains to in everything in nature. To 
whatever he says and does, down to every tone of 
the voice, every look of the eye, every motion of 
the body, every sentence uttered, thought con- 
ceived, feeling felt, and mental action whatsoever. 
Those who look like animals of one kind or another, 
also resemble them in character. That is, some 
have both the lion and bull-dog, or eagle or squir- 
rel expression of the face, and likewise have traits 
of character. 

Tiger men are always spare, muscular, full over 
the eyes, large mouth, and eyes slanting downward 
from their outer to inner angles, and human beings 
thus characterized are fierce, domineering, revenge- 
ful, most enterprising, not over-humane, a terror 
to enemies and conspicuous wherever they go. 
Horses, oxen, doves, sheep and foxes, also have 
their men and women cousins with their accom- 
panying characters. These resemblances to ani- 
mals are more easily observed than described, but 
the forms of the mouth, nose and chin are the best 
guides for observation. 

The walk is peculiarly expressive of the charac- 



INDICATIONS OF CHARACTER. 323 

ter, as is even every other motion. When the life 
principle is slack and its manifestations are lax, 
the walk is dragging, shuffling and loose jointed. 
A walk and cast of motion full of snap and vim, 
signify character full of energy and power, while 
the shiftless, inert person has a shiftless, lagging 
dragging walk and mode of movement. An abun- 
dance of life magnetism keeps every muscle ten- 
sioned, and renders the walk light and springy, 
An angular cast of motion full of short, sharp turns 
signifies a short, curt, snappy, uneven, impatient 
irritable cast of character; whereas an even, gentle, 
waving, spherical cast of character, denotes a har- 
monious, consistent, gentle, sweet and regular 
sameness of character, corresponding to the walk. 
A shuffling walk which often hits the heels is a very 
poor sign, as is stubbing toes. Those who do or 
walk thus will never make anything of any account ; 
while those who pick their feet up clear from the 
ground, handle them nimbly, and walk with a 
light limber-jointed motion will carry these char- 
acteristics in and throughout all they do. Fast 
walkers do everything else fast, and slow walkers 
think, feel and live slowly; in fact are slow moulded 
generally. A genteel, pretty, tasty walk grows 
out of a like spirit nature, which executes everything 
else likewise; while a slouchy, ugly and ungainly, 
unslightly walk comes from a slouching spirit 
fountain. 

It is well to cultivate the acquaintances of those 
you admire the walk of, but shun those whose walk 
is repellent or has any unpleasant feature about it. 
A dainty, affected, try-to-move-pretty walk sig- 
nifies a make-believe, artificial life; one thing in- 



324 CARE OF THE BODY IN HBAI/fH AND DISEASE. 

side, another out. Such persons are not genuine 
heart in hand creatures, but insincere and full of 
false pretenses. Powerful and powerless walks 
signify the former a powerful character and the 
latter a powerless character, stopped by straws 
and mindful of trifles as well as swayed by them. 
Other walks and corresponding traits of character 
will no doubt be suggested to the reader by these 
examples. 

The laugh is peculiarly expressive of the charac- 
ter. A loud laugh signifies power; a soft one soft- 
ness. A coarse, gross, hoarse laugh, a coarse, low 
bred vulgar person. A hearty side-shaking laugh, 
a whole soul energetic character. A muffled laugh, a 
self suppression and control. A spontaneous out- 
bursting laugh, spontaneity and sincerity of char- 
acter. Short giggles with little force, but rapid; 
a rapid way of doing little things without much 
force of character, while loud, hearty giggles signify 
power and speed throughout the character. 

Refinement, purity, power, firmness, force, good- 
ness, affection, temper, health and the want of 
either, as well as their amount, and in fact all other 
states of all other elements speak out in the voice 
in general, and laugh in particular, with a dis- 
tinctness better understood by being observed 
than can be described with words. 

Many kindred signs indicate the general and 
special traits of character ; but each reader will have 
to observe for himself as to what particular laughs, 
walks, and other signs indicate in any particular 
instance. 



INDICATIONS OF CHARACTER. 325 

PROPORTION A LAW OF THE MENTAL FACULTIES. 

The mind is governed by a law of proportionate 
action among its faculties. All excesses and all 
defects tend to weaken character; as lemonade to 
be right good must contain about as much sweet 
as sour, and sour as sweet, so perfection of charac- 
ter requires an equal proportion among all the 
faculties. An excess of the propensities over the 
moral faculties predisposes to passional excesses, 
which is neither favorable to happiness nor virtue, 
because unguided and unrestrained by the higher 
faculties; and in that proportion puts us on a level 
with the beasts that perish, or when there is a great 
predominance of the upper faculties over the lower, 
makes one in that proportion too good for his own 
good. Men naturally make game of these very 
good, innocent, harmless people, whose goodness 
degenerates into softness, just as sheep are preyed 
upon by fierce animals. All should be executive 
in proportion as they are good, and the better, 
the more forcible they are lest their force becomes 
aggression or else perverted to wrong uses. Avoid 
both being so good as to be good for nothing, and 
so selfish as to overrule goodness; but be selfish 
enough to provide well for personal wants, yet 
moral enough not to allow the selfish faculties to 
wrong others. Great men have great faults has 
passed into a proverb because they have some 
powerful faculties with others very weak or bad. 
One with predominent perceptives and weak reason 
can collect and retain knowledge, excel in scholar- 
ship, and talk easily, yet is superficial and unable 
to ascend from facts to first causes, and lacks judg- 



326 CARE) OF THE BODY IN HEALTH AND DISEASE. 

ment and contrivance; but those in whom the per- 
ceptives are deficient and with strong reasoning 
powers, are theoretical but have a wretched mem- 
ory, and are unable to command their knowledge 
or bring their superior reasoning powers into prac- 
tical use, are merely abstract and always imprac- 
ticable; and though they know how to reason, 
their command of facts are too limited to give them 
the requisite premises to form correct conclusions- 
whereas, when both are equally developed the per- 
ceptives furnish abundant material for the reflec- 
tives to work up sound conclusions and the two 
together give general talents, and constitute a well 
balanced, philosophical mind, creating sound com- 
mon sense, correct judgment, and enlarged views 
in place of those warped conclusions, fallacious 
opinions and abortive efforts, consequent on the 
predominance of either over the other. I^arge 
reasoning powers with small expression gives plenty 
of excellent ideas which are spoiled by a scarcity 
of words; while large expression with weak reason- 
ing powers talks a great deal and says very little, 
and gives plenty of words along with few and poor 
ideas, while their equality gives as many words as 
ideas and as many ideas as words. A woman with 
small love for her husband and large affection for 
her children, prizes and dotes on her children, yet 
cares little for her husband; while one with large 
love for her husband and small affection for her 
children, cares for and dotes on her husband, yet 
neglects her children; whereas, one with large love 
for both worships, does for, and enjoys both. It 
is plain that the last named would be far the hap- 
piest in her family and her family in her. Kxces- 



INDICATIONS OF CHARACTER. 327 

sive acquisition with little caution speculates wildly, 
contracts debts beyond means of payment, and 
loses all, and with deficient reasoning powers de- 
vises poor ways and means of making money, al- 
ways grasping one straw after another only to sink 
the deeper; while these faculties equally developed, 
ove money but not inordinately, lay out feasible 
plans, yet pay all dues and enjoy business and 
money, thus gratifying both these faculties and all 
the others. Excess of ambition over talents makes 
a laughing stock of talent over self-trusts, a bash- 
ful genius, who would be better off with more brass, 
even 'though with less genius. How much better 
equal dignity and worth over worth without dig- 
nity or dignity without worth. 

Those who have large dignity, firmness and force, 
with moderate ambition, conscience and intellect, 
are proud, hauty, imperative, domineering, over- 
bearing and selfish, yet have too little intellect and 
moral worth to support their authorative preten- 
tions ; whereas the equal development of all the 
faculties gives superior talents and moral elevation, 
along with that self-respect which supports the 
finished gentleman to mental and moral greatness, 
thereby both being and making happy. Excessive 
firmness with deficient caution makes one decide 
without proper reflection, and to adhere stubbornly 
to previous decisions, while excessive caution with 
deficient firmness renders one afraid to decide 
either way, vacilating with false fears and afraid of 
shadows, whereas those with these organs equal, 
decide carefully, yet hold out persistently; first 
making sure that they are right and then going 
straight ahead, which is always the best, 



328 CARE OF THE BODY IN HEALTH AND DISEASE. 



CHAPTER XXIII. 

DOES CULTURE STRENGTHEN THE FACULTIES? 

Yes, to a very decided degree. Many facts without 
any opposing, prove that the more a faculty is 
exercised the more strongly and actively it be- 
comes, and the less it is exercised the weaker. We 
are not compelled to carry all our excesses and faults 
through life, though the tendencies of all the 
strong faculties in one is to become stronger and 
the weak ones still weaker. The larger the faculty 
the greater the pleasure taken in its exercise, 
and therefore the more easy and continual is its 
action which naturally reincreases its size and ac- 
tivity; while the weaker the faculty is the less 
pleasure is taken in its action, and therefore the 
less it is exercised, so that it becomes diminished 
by inaction; yet where the will power is sufficient 
this tendency can be counteracted, and the power 
of any required faculty be increased or diminished 
at pleasure. Any law that governs a part of any 
given class of functions of necessity governs them 
all; then since culture so wonderfully increases the 
physical activities, why not equally the mental? 
The old maxim that practice makes perfect is es- 
pecially true of the exercise of all our feelings, pas- 
sions, tastes, moral sentiments, intellectual facul- 
ties, mind and body. To give some illustrations, 
the more the gallant courts female society the more 
he loves it, but the less the constitutional bachelor 



DOES CULTURE STRENGTHEN THE FACULTIES? 329 

visits the ladies the less he cares to see them. A 
fond husband loves his family the more he is with 
them at home; while being much from home and 
family weans any and all from them. War has a 
powerful effect to increase martial courage. Fac- 
ing danger always emboldens. The more money 
the miser makes the more he loves it, while the want 
of the spendthrift increases his expenditures. 
Children or horses, when frightened, become much 
more timid after than before. The more we are 
praised or indulge in fashionable displays the more 
we are carried away with them. 

The more we use tools the more skillful we be- 
come in their use; whereas, we grow awkward by 
their disuse. The more one acts the better is his 
acting, and the less, the poorer. The more we read, 
study, think or speak, the more natural and skillful 
we do either, and the reverse. The more we sing 
or play the more expert singers or players we thereby 
become. Any kind of memory is stregthened by 
culture. It you really must have an errand done 
give it to one who does a hundred errands a day. 
If you give it to one who rarely does an errand it 
will most likely be forgotten. The difference ob- 
served between the talents of great men and common 
ones is no doubt partly consequent on the degrees 
of culture that each has of his natural gifts. Na- 
ture makes some of it of course but it requires cul- 
tivation to perfect it. Natural gifts, be they ever 
so great, accomplish very little unless they are 
disciplined; while moderate talents carefully cul- 
tivated work well. 

Every intellectual faculty, every moral virtue, 
a r nd every animal propensity can be strengthened 



33° CARE OF THE BODY IN HEAI/TH AND DISEASE. 

by cultivation, often beyond the highest expectations. 

ivOVE. 

Love has been defined as a tender emotion ex- 
isting between the sexes; and as it exerts such an 
influence, either for making or unmaking of many 
person's characters; also for making them happy 
or unhappy, I will here quote a description of love, 
its cultivation and restraint, from Prof. O. S. Fow- 
ler's phrenology. The terms Large, Full, Average, 
Moderate and Small, relate to the faculties of sus- 
ceptibilities to love: 

"It creates in each sex, admiration and love of 
the other. Renders woman winning, persuasive, 
urbane affectionate, loving and lovely, and develops 
all the feminine charms and graces ; makes man 
noble in feeling and bearing, elevated in aspiration, 
galant, tender and bland in manner, affectionate 
toward woman, highly susceptible to female charms, 
and clothes him with that dignity, power and per- 
suasiveness which characterize the male. 

Large — Are admirably sexed, or a well nigh perfect 
male or female, literally idolize the opposite sex, love 
almost to insanity; treat them with the utmost 
consideration, cherish for them the most exhaulted 
feeling of regard and esteem as if they were superior 
beings; have the instinct and true spirit and tone 
of the male or female in a pre-eminent degree, must 
love and be beloved, are sure to elicit a return of 
love, because intuitively winning, attractive and 
attracted; almost worship parents, brothers and 
sisters of the opposite sex; with organic quality 
large and the other social organs large have the 
conjugal intuition in a pre-eminent degree, assimi- 



IvOVE. 331 

late and conform to those loved and become per- 
fectly united, and with constancy large manifest 
the most clinging fondness and utmost devotion, 
and are made or unmade for life by the state of the 
affections, have many friends and admirers among 
the other sex; love young and most intensely, and 
are powerfully influenced by the love element for 
good or evil, according as it is well or ill-placed, 
with friendship and constancy, large will mingle 
pure friendship with devoted love, cannot flourish 
alone but most have a matrimonial mate w r ith whom 
to become perfectly identified, and whom to invest 
with almost superhuman perfection, wdth large 
beauty and a mental temperament added will ex- 
perience a fervor and intensitive of love, amount- 
ing almost to ecstasy or romance, can marry those 
only who combine refinement of manners with 
correspondingly strong attachments; with parental 
love and kindness also large are eminently qualified 
to enjoy the domestic relations and be happy in 
home as well as to render home happy, with inhab- 
itiveness also large will set a high value on a house 
and place, long to return home when absent, and 
consider family and children the greatest of life's 
treasures; with large conscience added will keep 
the marriage relations inviolate, and regard un- 
faithfulness as the greatest of sins, with force large 
will defend the object of love with great spirit and 
resent powerfully any indignity offered them; with 
appetite large will enjoy eating with loved one and 
family dearly; with ambition large cannot endure 
to be blamed by those beloved; with caution and 
secretion large will express love guardedly and 
much less than is experienced, but w T ith secretion 



332 CARE OF THE BODY IN HEAI/fH AND DISEASE. 

small will show in every look and action the full 
unveiled love of the soul ; with firmness and dignitd 
and constancy large will sustain interrupted love 
with fortitude yet suffer much damage of mind 
and health therefrom, but with dignity; moderate 
will feel crushed and broken down by disappoint- 
ment; with the moral faculties predominent can 
love those o Ay whose moral tone is pure and ele- 
vating; with predominent beauty and only average 
intellectual faculties will prefer those who are showy 
and gay to those who are sensible yet less beautiful ; 
with mirth, time and tune will love dancing, lively 
company, etc. 

Full — Possess quite strong susceptibilities of love 
for a congenial spirit, are capable of much purity, 
intensity and cordiality of love if its object is about 
right, with friendship and kindness large will be 
kind and affectionate in the family; with a highly 
susceptible temperament will experience great in- 
tensity of love, and evince a good degree of mascu- 
line or feminine excellence. Average are capable 
of fair conjugal attachments and calculated to feel 
and exhibit a good degree of love provided it is 
properly placed and fully called out, but not other- 
wise experience a greater or less degree of love in 
proportion to its activity, as a man quite attached 
to mother, daughters and sisters and fond of female 
society and endowed with a fair share of the mas- 
culine element, yet not remarkable for its perfec- 
tion; as a woman quite winning and attractive, yet 
not particularly susceptible to love; as a daughter 
fond of father and brothers and desirous of society 
of men, yet not especially so, and capable of a fair 
share of conjugal devotedness under favorable 



LOVE. 333 

circumstances, combined with an ardent tempera- 
ment and large friendship and beauty have a pure 
and platonic cast of love, yet cannot assimilate 
with a coarse temperament or a dissimilar phre- 
nology, are refinded and faithful, yet have more 
friendship than passion; can love those only who 
are just to the liking; with caution, and secretion 
large will express less love than is it It, and that 
equivocally and by peace meal, nor then until the 
loved one is fully committed; with caution, ambition 
and worship large and dignity small are diffident 
in promiscuous society, yet enjoy the company 
of a select few of the opposite sex. 

Moderate — Are rather deficient though not pal- 
pably so in the love element, and averse to the 
other sex, love their mental excellencies more than 
personal charms show little desire to caress or be 
caressed, and find it difficult to sympathize with 
a conjugal partner unless the natural harmony 
between both is well nigh perfect ; care less for mar- 
riage, and can live unmarried without inconveni- 
ence; with constancy large can love but once and 
should marry the first love, because the love prin- 
ciple will not be sufficiently strong to overcome the 
difficulties incident to its transfer, or the want of 
congeniality, and find more pleasure in other things 
than in matrimonial relations; with an excitable 
temperament will experience greater warmth and 
ardor than depth or uniformity of love ; with beauty 
and organic quality large are fastidious and over- 
modest, and terribly shocked by illusions to love; 
pronounce love a silly farce, and only fit for cracked- 
brain poets; with ambition large will soon become 
alienated by rebukes and fault finding ; with friend- 



334 CARE OF THE BODY IN HEALTH AND DISEASE. 

ship and the moral and intellectual faculties large 
can become strongly attached to those who are 
highly moral and intellectual, yet experience no 
affinity for any other, and to be happy in marriage 
must base it in the higher faculties. 

Small — Dislike the opposite sex and distrust 
and refuse to assimilate with them; feel little sexual 
love or desire to marry; are cold, coy, distant and 
reserved toward the other sex; experience but little 
of the purifying elevating influence of love, and 
should not marry because incapable of appreciating 
its relations and making a companion happy and 
are passively continent. 

TO CULTIVATE: Mingle much in the society 
of the other sex; observe and appreciate their ex- 
cellencies and overlook their faults; be as gallant, 
gentlemanly or ladylike, inviting, prepossessing, 
lively and entertaining in their society as you know 
how to be, and always an the alert to please them; 
say as many complimentary and pretty and as few 
disagreeable things as possible; that is, try to cul- 
tivate and play the agreeable; if not married, con- 
template its advantages and pleasures and be pre- 
paring to enjoy them; if married get up a second 
and improved edition of courtship; re-amour 
both yourself and conjugal partner by becoming 
just as courteous, loving and lovely as possible; 
luxuriate in the company and conversation of those 
well sexed, and imbibe their inspiriting influence; 
be less fastidious and more free and communica- 
tive; establish a warm cordial intimacy and friend- 
ship for them, and feast yourself on their mascu- 
line or feminine excellency; if not married, marry 
and cultivate the feelings as well as live the life of 



hovn. 335 

a true and hearty sexuality; to restrain, simply 
direct this love element more to the mental and less 
to the personal qualities of the other sex; admire 
and love them more for their minds than bodies, 
and more for their moral purity and conversational 
powers, than as instruments of passion; seek the 
society of the virtuous and good but avoid that of 
the vulgar; should mingle in their society to derive 
moral elevation and inspiration therefrom, and be 
made better not to feed the fires of passion and 
yield to their moulding influences for good; should 
be content to commune with their spirits; should 
sanctify and elevate the cast and tone of love and 
banish its baser forms; especially should lead a 
right physiological life; avoid tea and meats and 
abstain wholly from coffee, tobacco and all forms 
and degrees of alcoholic drinks; wines and beer in- 
cluded; exercise much in the open air; abstain 
wholly from carnal indulgence; work off your vital 
force on other functions as a relief of this, bath 
daily, eat sparingly, study and commune with 
nature; cultivate the pure intellectual and moral 
as the best means of rising above the passional, 
and put yourself on a high human plain throughout ; 
remember that you require its purification, eleva- 
tion and right direction rather than restraint be- 
cause it is more perverted than excessive, and that 
the inflamed state of the body irritates and per- 
verts this passion; of which a cooling regimen is a 
specific antidote. Love, how inexpressively sacred. 
Is Divine worship any more so? What other hu- 
man emotion penetrates quite as deeply into the 
very rootlets and soul of human existence as does 
this tender sentiment? For what does a man 



336 CARE OF THE BODY IN HEALTH AND DISEASE. 

launch out as freely as to the female he loves ? 
She generally gets more of his time, money, feelings 
and soul than his Saviour. Even appetite gets 
but moiety as much of either. All human experi- 
ence concur in pronouncing this man's one grand 
master passion; say all ye who have ever loved, 
and who matured but has; what woman's senti- 
ment ever struck away down in the very rootlets 
of your being as did this Divine sentiment? " 



Friendship. 337 



CHAPTER XXIV. 

FRIENDSHIP. 

Aristotle the philosopher divided friendship 
into three classes: 

First, friendship for the useful, and second friend- 
ship for the pleasant, and third friendship between 
the good. In case of friendship for the useful the 
friendship ceases with the motive as between trades- 
man and customer; in the case of friendship for 
the pleasant there is no motive except passive 
enjoyment; and in the case of friendship between 
the good it is based on merit and affection alto- 
gether, and may exist in the distance or between 
persons that are separated. 

To illustrate the various strengths of friendship 
I will introduce a passage here from Professor 
Fowler's phrenology. The terms Large, Average 
and Small refer to the faculties of friendship: 

"Description, cultivation and restraint of friend- 
ship. 

Large — Love friends with the utmost tenderness 
and intensity and will sacrifice almost anything 
for their sake, readily form friendships and attract 
friendly regards in return, must have society of 
some kind, with force and destruction full, defend 
friends with spirit and resent and retaliate their 
n juries, with dignity moderate, take character 
from associates, with acquisition moderate, allow 
riends the free use of purse, but with acquisition 



33§ CARE OF THE BODY IN HEALTH AND DISEASE. 

large will do more than give, with kindness and 
ambition moderate and acquisition only full, will 
spend money freely for social gratification, with 
dignity and force large must be first or nothing, 
but with a only average and large ambition, kind- 
ness, conscience, beauty, and reasoning organs, 
will have many friends and but few enemies; be 
amiable and universally beloved, with large even- 
tuality will remember with vivid emotions bygone 
scenes of social cheer and friendly converse; with 
large reasoning organs, will give good advice to 
friends and lay excellent plans for them, with 
smaller secretion and larger moral organs, will not 
believe ill of them, and dread the interruption of 
friendship as the greatest of calamities; willingly 
make any sacrifice required by friendship, and evince 
a perpetual flow of that commingling of soul and 
desire to become one with others which this faculty 
inspires; with appetite large love the social banquet 
and set the best before friends; with ambition large, 
set the world by their commendation but are ter- 
ribly cut by their rebukes; with the moral faculties 
large, seek the society of the moral and elevated 
and can enjoy the friendship of no others. With 
the intellectual large, seek the society of the intel- 
ligent, with expression large and secrecy small, 
talk freely in company; and with mirth and beauty 
also large, are full of fun, and give a lively jocose 
turn to conversation, yet are elevated and refined. 
With dignity large, lead off in company and give 
tone and character to others; but with it small, 
receive character from friends; and with imitation 
large are liable to copy their faults as well as vir- 
tues. With caution, secretion and ambition large 



FRIENDSHIP. 339 

are apt to be jealous of regards bestowed upon 
others and exclusive in the choice of friends, having 
a few select rather than many commonplace. 

With large causality and comparison, love phil- 
osophical conversation, literary societies etc., and 
are every way sociable and companionable. 

Full — Make a sociable warm-hearted friend who 
will sacrifice much on the alter of friendship, yet 
offer it up on the alter of stronger passions. With 
kindness large, will cheerfully aid friends, and have 
a few warm ones, yet only few; but perhaps many 
speaking acquaintances, and with the higher fac- 
ulties generally large will be a true good friend; 
yet by no means enthusiastic. The combinations 
under friendship large apply to it when full, allow- 
ance being made for its diminished power. 

Average — Are capable of tolerably strong friends, 
yet their character is determined by the larger 
faculties; enjoy present friends, yet sustain their 
absence. With large acquisition, place business 
before friends, and sacrifice them whenever they 
conflict with money making. With kindness large, 
are more sympathetic than affectionate, and relish 
friends, yet sacrifice no great for their sake. With 
love large, love the person of the other sex more 
than their minds, and experience less conjugal 
than animal passion; with ambition large, break 
friendship when ridiculed or rebuked; and with 
secretion large and conscience only average, can- 
not be trusted as friends. 

Moderate — Love society somew^hat, and form a 
few but only few attachments, and these only par- 
tial; may have many speaking acquaintances, but 
few intimate friends. With large force and destine- 



340 CARE) OF THE BODY IN HEALTH AND DISEASE. 

tion, are easily offended with friends, and seldom 
retain them long. With large kindness, will be- 
stow services and with moderate acquisition, money 
more readily than affection; but with the selfish 
faculties strong, take care of self first and make 
friendship subservient to interest. With large 
or very large force, destruction, dignity, ambition 
and acquisition, will serve self first and friends 
afterwards, and form attachments yet break them 
when they conflict with the stronger faculties. 
With large secretion and moderate conscience, 
will be double-faced and profess more friendship 
than possess. 

Small — Think and care little for friends; dislike 
copartnership, and are cold hearted, unsocial and 
selfish; take little delight in company but prefer 
to be alone; have few friends and with large selfish 
faculties, many enemies, and manifest too little 
to exert a perceptible influence upon character. ' ' 

It has been said that the cultivation of friendship 
is as important as the blessings are numerous and 
great that it confers. The friendless, whether 
they be so by poverty or wealth, are indeed pitiable; 
while a congenial spirit is a perpetual feast in itself 
and a source of comfort in trouble. 

By a natural law of our mind the actions of the 
faculties in one awakens them in all other beholders ; 
while stupidity leaves them inactive, and mixing 
up with others arouses all our moral and intellec- 
tual faculties to that sustained activity which 
develops them for future efforts. Nothing is as 
fatal to the faculties of men as inertia which often 
comes of loneliness, nor is there anything else so 
beneficial or happyfying as that healthy mental 



FRIENDSHIP. 34I 

stimulus provoked by the association of others. 
Without this contact with men, ambition, imita- 
tion, taste, worship, kindness, and expression must 
starve out or rust to death. 

Neighbors should be vastly more social than 
they are; they should always be exchanging pleas- 
ant remarks and joining in social gatherings and 
meetings of various kinds, extending hospitalities, 
visits etc. Families should be still more familiar 
and cosey, and vanish all rivalries and animosities. 
We often hear it said, " business before friends,' 
but it should rather be "business with friends," 
and all business firms should make friends of each 
other first as their best means of success. Many 
men enjoy but a mere fraction of the pleasures 
and profits that may be derived from this faculty. 

When a young man secures the friendship of a 
gentleman he will always be on the alert to help 
him out in time of need; while every enemy will 
treasure up something ill until some suitable op- 
portunity presents itself, and then bestow his grudge. 
The young gentleman and the young lady also, 
should be very judicious in the selection of their 
friends, and form the very best associations possi- 
ble; yet they should not prove themselves hostile 
to those not just to their liking; they should, how- 
ever, never be unduly led by them. 

In order to cultivate this faculty one should go 
more into society, associate more freely with those 
around, be less exclusive and distant, and strive 
to be as companionable and familiar as he well 
knows how. 



342 CARE OF THE BODY IN HEALTH AND DISEASE. 



CHAPTER XXV. 

CONVERSATION AND GOOD MANNERS. 

Conversation and good manners, next to intel- 
lectual and moral attainments, holds one of the 
highest places that can be obtained or that human 
beings are endowed with. Our mental capacity- 
is regarded as one of the most exalted departments 
of nature; and this faculty, that of manners and 
conversation, is our main medium of manifestation; 
therefore, anything that improves our communi- 
cating power must be regarded as of the highest 
importance. The mind itself crowns our nature 
with the second highest ornament and promotes 
personal and general enjoyment beyond computa- 
tion. 

Lord Chesterfield has well said that "good con- 
versational powers are an open and universal letter 
of recommendation." They often charm those 
who are naturally averse to us. They embody 
the most perfect of all means of communicating 
instruction; conveying ideas, feelings, and all the 
operations of the mind. He can persuade as he 
will who weilds them, and thus become the highest 
instrumentality of success. They give their pos- 
sessor command over mind. It has been consid- 
ered a great gift to be able to mould or fashion the 
marble block into the image of humanity, but to 
mould character and control opinion and deter- 
mine conduct is the highest power bestowed upon 



CONVERSATION AND GOOD MANNERS. 343 

men, because instrumental of the greatest amount 
of happiness. 

In order to illustrate the powers and accomplish- 
ments of the higher order of attainments by speech 
I will here quote from Professor Fowler's phrenol- 
ogy in relation to it: 

"Eloquence man's second glorious gift. Be- 
hold Demosthenes rousing electrified throngs till 
they seize their arms and wildly exclaim, 'let us 
march against Philip, let us conquer or die.' Be- 
hold a Cicero weilding the most powerful sceptre 
on earth, by his flowing and effective eloquence. 
Behold a Burke speaking not mainly to the few 
thousand crowded around him, but to a mighty 
Empire; to the entire civilized world for ages after 
his voice was hushed in death. Behold a Patrick 
Henry, enchanting and arousing his fellow citizens 
at home and his compatriots in Congress till he 
prefaces and ushers in that immortal declaration 
of human freedom, which is now undermining 
every throne and dinasty on earth, and will soon 
enfranchise the race itself, and give to oppressed 
humanity forever the glorious birthright of liberty, 
civil, ecclesiastical and intellectual. Behold O'Con- 
nell wherever he opened his mouth, a nation 
at his feet hung on his words. He said forbear, 
and they forbore, 'though lashed up to desperation 
and frenzy by oppression and starvation. If he 
had said fight, nations would have rushed to mor- 
tal combat. Give me eloquence in the forum or 
on paper, and I will mould mind, fashion, motive 
and develop soul. Will wean erring humanity 
from its fooleries and its errors. Make sinful 
miserable men, virtuous and happy. Reform and 



344 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

adorn my country till it becomes the model nation 
of the world, and even make earth another Eden. 
Only give me eloquence, I care not what you take; 
take this boon, I care little for what is left. ' ' 

Can delivery be improved? Yes, to an aston- 
ishing extent. Undoubtedly many, many readers 
and conversationalists with very ordinary natural 
gifts, might by cultivating their natural gifts and 
graces, equal or surpass many of our good speakers, 
both in conversation and delivery. Conversation 
furnishes the very best opportunity for cultivating 
and improving style; for while others are talking 
we can both listen and arrange our own ideas and 
language. Those who cannot be really eloquent 
in conversation cannot be eloquent anywhere. 
It requires neither interest nor excitement, because 
both are brought to the highest pitch of healthy 
action. There is also something in the very nature 
of this conversational interchange of ideas and 
feelings in answering and replying and answering 
again is in every way suited to elicit mental action 
and beauty of sentiment, and also to facilitate this 
eloquent, charming, forcible expression. In public 
speaking the sentences must be made too rapidly 
to allow of that strength of thought and arrange- 
ment of ideas and sentences, or that beauty of 
diction which is fully provided for in conversation; 
but these faculties are far too little improved. To 
be a good converser one must exercise care and 
judgment in casting his sentences. One may talk 
a lifetime without any effort to improve, and make 
no progress in conversation. 

Frequent and protracted talks with men of wide 
culture are highly useful. It would appear that 



CONVERSATION AND GOOD MANNERS. 345 

there are many men who do not even know how or 
attempt to improve conversation. It is like many 
other exercises, less tedious after one becomes 
versed in it than in the exercise of improving. It 
has been said that only few men talk ideas and fewer 
still, take pains to express them well; but when we 
do meet those highly gifted in conversation hours 
become short like minutes to us, so much more do 
we enjoy their society than in ordinary life. To 
excel in conversation, one should exercise patience, 
and observe the law of good breeding of waiting 
until others finish before he begins. 

By the careful correction of faults in conversa- 
tion, improvement is certain to follow, and will 
enable us to diminish existing blemishes and add 
many strokes of beauty and impressiveness, and 
often enable us to literally charm our hearers by 
the perfection of our diction and composition, 
and contribute more to the happiness of ourselves 
and fellowmen than if we possessed great fortunes. 

To communicate well is more important than 
the quantity of words used. It is always more 
essential to express ourselves elegantly and forcibly 
than to rattle away without sense or beauty. When- 
ever a few appropriate words will express more 
than many, they accomplish more and are prefer- 
able. In general the fewer words, the better; 
provided however they fully convey the precise 
meaning intended. 

Perspicuity is the first and highest excellence 
of the converser. We speak and write solely to be 
understood, and the better you enable a listener 
and reader fully to comprehend your precise ideas 
the more perfect your communicating powers are; 



346 CARE OF THE BODY IN HEAI/TH AND DISEASE. 

so one to converse well should first seek perspicuity, 
and thus make his mental operations perfectly 
clear to the listeners or readers, so that they can 
neither mistake nor doubt. Impressiveness is an- 
other very important quality of conversation. 
We speak or write solely to impress our own mental 
operations on other minds; then we should so ex- 
press them as to render the transfer entire and com- 
plete. In the accomplishment of these ends more 
perhaps depends on the general arrangement of 
sentences than on the words used. There is a 
right and a wrong arrangement for every division, 
clause and word of every discourse, as much as for 
the hand, eye, or any part of the body. The differ- 
ence in the effect produced by transposing clauses 
and words is indeed great. It is not hard for any 
ordinary scholar to perceive this difference. In 
order for self-improvement one should frame sen- 
tences a'nd then alter and modify in order to per- 
fect them. This is a most excellent discipline as 
well as a promotor of forcible and correct conver- 
sation. 

Ornament is a desirable part of conversation 
Nature adorns all her works, and indeed is one 
grand field of beauty. All the vegetable world 
with its charming flowers, the human form and face, 
all creation is adorned with beauty; yet what is 
more perfectly enchanting than elevated sentiments 
and sublime ideas elegantly expressed? We may 
gaze on a beautiful face, the highest order of beauty 
of form, but let us behold beauty of soul as mani- 
fested by words. What else embodies more of 
the truly divine? Has nature provided so amply 
for adorning physical works and failed in further 



CONVERSATION AND GOOD MANNERS. 347 

ornamenting her highest work of all? Has she 
stamped so high a grade of beauty on the human 
form and face and yet neglected to adorn its prin- 
cipal avenue of manifestation? No, such an orna- 
ment has been created. We speak properly of 
flowery language and an ornate style. Give me 
an elegant style; I care nothing for gaudy attire 
or splendid equipage, and yet there are many who 
spend hours daily in putting on outward adorn- 
ments, often almost amounting to deformities and 
tolerated only on account of being fashionable, 
without any effort being made to beautify the 
mind, or polish its highest order of manifestation. 
Let us develop by culture that beauty of style con- 
ferred on all by nature and on some so lavishly. 
If men would but take half the pains to ornament 
their conversation that they do on dress, every 
sentence would be charming, and every book en- 
chanting, and all interchange of ideas a perpetual 
feast. Let us all strive to beautify and perfect every 
sentence we utter or write. Simplicity is another 
important requisite in good style. Whatever is 
natural is therefore beautiful. And of this there 
is nothing more true than of the manner of ex- 
pressing ideas. A strained, far-fetched, artificial 
style is always ill-proportioned and imperfect. 
Our words should be placed in nearly or quite the 
same order on paper as in speech. One of the 
greatest of faults of modern style is its departure 
from this oral and natural standard. One should 
write as he speaks, and speak as he writes. In 
other words — his conversation should be as correct 
as if it had to go to print. Let simplicity be the ruling 



348 CARE OF THE BODY IN HEALTH AND DISEASE. 

characteristic in all you say and write. Whoever 
is natural in this respect is therefore elegant. 

As this chapter is headed, before I close, I will 
say a few words respecting good manners. 

As conversation is one of the chief factors in 
demonstrating manners. I dwelt more elaborately 
on that very important subject. Good manners 
is the out-growth of a true intelligent Gentlemen 
or Lady, and in order to improve our manners, 
as before said, we must improve our conversation, 
and next we should choose for our associates the 
intelligent and the well-bred. We should select 
those of high culture and those, who are refined, 
and those, who love the beauties of nature and 
shun the vulgar. 

The character of literature, we read imparts to 
us much of our characteristics. It, therefore, 
becomes a very important matter to select the 
proper books for our reading. What we learn 
in school, merely prepares us to become informed. 
We then have before us, that is after we quit school, 
some of the greatest lessons and problems to deal 
with that we meet with during life. Our literature 
should be of a chaste elevated, and ennobling char- 
acter. We should select books, that inform us 
on men and manners, which is really of far more 
use to us than our greek and latin, french and ger- 
man, or any other foreign language. To be able 
to tell just whom to trust and whom not, and whom 
to associate with, and whom not, is one of the most 
important forms of knowledge we can invest in. 



OCT 31 1904 



